Correlations Between Acute Coronary Syndrome and Novel Inflammatory Markers (Systemic Immune-Inflammation Index, Systemic Inflammation Response Index, and Aggregate Index of Systemic Inflammation) in Patients with and without Diabetes or Prediabetes

Figures & data

Table 1 Differences in Variables Between Groups of Patients. Values are Presented as Numbers (%) or Medians (IQR). P-values Were Calculated Using Pearson’s Chi-Square (Dichotomous Data) or Kruskal–Wallis H-Test (Non-Parametric Continuous Data); Subsets of Groups That Do Not Differ Significantly from Each Other For a Particular Variable at the p = 0.05 Level are Denoted with Consecutive Letters (a, b, …). For All Tests Df = 3

Total N = 493	No IGM, CCS, N = 166	IGM, CCS, N = 107	No IGM, ACS, N = 146	IGM, ACS, N = 74	X^2 (3)	H (3)	p-value
N of cases [♂/♀]	93 (18.9) / 73 (14.8) a	68 (13.8) / 39 (7.9) a	96 (19.5) / 50 (10.1) a	43 (8.7) / 31 (6.3) a	3.66	–	0.301
Age, [years]	68.63 (61.37–76.09) a	68.43 (61.45–75.11) a	63.99 (55.82–73.27) b	67.96 (60.67–76.37) a, b		13.50	0.004
BMI, [kg/m^2], N = 468	27.05 (26.61–30.48) a	28.72 (25.86–32.05) b	26.23 (24.22–29.39) a	29.39 (26.03–33.25) b		27.50	<0.001
Hyperlipidemia^† [yes/no]	85 (18.8) / 65 (14.4) a	48 (10.6) / 52 (11.5) a	86 (19.0) / 50 (11.1) a	38 (8.4) / 28 (6.2) a	5.47	–	0.140
Total cholesterol^† [mg/dL]	178.98 (148.57–217.15) a	160.16 (129.59–191.54) b	173.22 (145.14–205.55) a	162.71 (144.09–201.73) a, b	–	14.67	0.002
HDL^† [mg/dL]	56.26 (44.21–63.04)	46.52 (40.21–55.43) a	46.45 (38.23–52.39) a	42.78 (36.26–50.08) a	–	39.93	<0.001
LDL^† [mg/dL]	93.59 (71.68–128.56) a	78.68 (59.11–98.14)	101.81 (78.24–131.70) a	101.21 (71.84–121.31) a	–	24.67	<0.001
TG^† [mg/dL]	115.7 (81.52–158.12)	118.39 (90.49–172.11)	105.94 (85.03–139.00)	119.82 (84.68–163.26)	–	6.80	0.079
HTN [yes/no]	121 (24.5) / 45 (9.1) a	102 (20.7) / 5 (1.01) b	123 (25.0) / 23 (4.7) a, c	71 (14.4) / 3 (0.6) b, c	34.214	–	<0.001
Previous MI [yes/no]	40 (8.1) / 126 (25.6) a	34 (6.9) / 73 (14.8) a, b	58 (11.8) / 88 (17.9) b	35 (7.1) / 39 (7.9) b	15.48	–	0.001
Smoking [yes or in the past / no], N = 466	56 (12.0) / 99 (21.2) a, b	30 (6.4) / 72 (15.5) b	66 (14.2) / 74 (15.9) a	26 (5.6) / 43 (9.2) a, b	8.37	–	0.039
Leukocytes [k/μL]	7.3 (5.80–8.38)	7.50 (6.18–8.48)	7.20 (6.23–8.40)	7.80 (6.38–8.73)	–	4.49	0.213
Neutrophils [k/μL]	4.33 (3.37–5.14)	4.37 (3.48–5.49)	4.26 (3.51–5.10)	4.69 (3.72–5.61)	–	4.29	0.231
Lymphocytes [k/μL]	1.85 (1.49–2.40)	1.92 (1.55–2.39)	1.91 (1.55–2.36)	1.92 (1.58–2.22)	–	0.18	0.981
Monocytes [k/μL]	0.67 (0.54–0.83)	0.66 (0.51–0.80)	0.66 (0.53–0.79)	0.69 (0.57–0.86)	–	4.37	0.224
Platelets [k/μL]	209.00 (179.50–249.00)	200.00 (177.00–236.50)	214.50 (180.00–251.25)	220.00 (179.50–252.75)	–	3.24	0.356
SII	467.55 (354.09–610.32)	439.06 (338.79–640.84)	470.06 (357.69–623.73)	564.88 (370.28–747.78)	–	6.22	0.101
SIRI	1.53 (1.02–2.11)	1.40 (0.93–2.13)	1.43 (1.02–2.08)	1.68 (1.11–2.48)	–	4.81	0.186
AISI	340.28 (238.97–538.66)	352.82 (224.09–573.71)	353.86 (209.13–542.41)	307.50 (196.33–520.76)	–	2.20	0.533

Note: ^† N = 452.

Abbreviations: ACS, acute coronary syndrome; CCS, chronic coronary syndrome; TG, triglycerides; HTN, hypertension; MI, myocardial infarction; SII, systemic immune-inflammation index; SIRI, systemic inflammation response index; AISI, aggregate index of systemic inflammation.

Table 2 Binomial Logistic Regression Analysis of Factors Associated with ACS Diagnosis in Patients with and without DM/preDM

		Category	B	S.E. B	Wald	p-value	Odds Ratio (95% CI)
No DM/preDM	BMI	–	−0.113	0.04	7.798	0.005	0.893 (0.825–0.967)
	Age	–	−0.021	0.016	1.841	0.175	0.979 (0.949–1.01)
	Smoking	Yes or in the past	0.227	0.329	0.479	0.489	1.255 (0.659–2.391)
	Previous MI	Yes	0.7	0.333	4.424	0.035	2.013 (1.049–3.864)
	Sex	Men	−0.528	0.342	2.384	0.123	0.59 (0.302–1.153)
	HTN	–	0.695	0.393	3.132	0.077	2.004 (0.928–4.327)
	HDL	–	−0.077	0.015	26.302	<0.001	0.926 (0.899–0.954)
	LDL	–	0.004	0.006	0.465	0.495	1.004 (0.992–1.016)
	TG	–	−0.012	0.004	9.395	0.002	0.988 (0.98–0.996)
	Hyperlipidemia	Yes	0.284	0.468	0.369	0.544	1.329 (0.531–3.324)
	SII	–	0.002	0.001	2.643	0.104	1.002 (1–1.004)
	SIRI	–	−0.456	0.278	2.692	0.101	0.634 (0.368–1.093)
	AISI	–	−0.001	0.001	1.686	0.194	0.999 (0.998–1)
	Const.	–	9.018	2.125	18.016	<0.001	8253.235
DM/preDM	BMI	–	−0.031	0.045	0.485	0.486	0.969 (0.888–1.058)
	Age	–	−0.017	0.027	0.388	0.533	0.983 (0.932–1.037)
	Smoking	Yes or in the past	−0.142	0.501	0.081	0.776	0.867 (0.325–2.317)
	Previous MI	Yes	0.359	0.436	0.678	0.41	1.432 (0.609–3.363)
	Sex	Men	−0.412	0.486	0.72	0.396	0.662 (0.256–1.716)
	HTN	–	−0.351	1.07	0.108	0.743	0.704 (0.086–5.73)
	HDL	–	−0.061	0.022	7.707	0.005	0.941 (0.902–0.982)
	LDL	–	0.016	0.007	4.867	0.027	1.016 (1.002–1.031)
	TG	–	−0.006	0.005	1.926	0.165	0.994 (0.985–1.003)
	Hyperlipidemia	Yes	0.298	0.621	0.23	0.631	1.347 (0.399–4.547)
	SII	–	0.001	0.001	1.361	0.243	1.001 (0.999–1.004)
	SIRI	–	0.102	0.282	0.131	0.717	1.108 (0.637–1.925)
	AISI	–	0	0.001	0.001	0.98	1 (0.999–1.001)
	Const.	–	3.185	3.141	1.028	0.311	24.162

Abbreviations: ACS, acute coronary syndrome; CCS, chronic coronary syndrome; TG, triglycerides; HTN, hypertension; MI, myocardial infarction; SII, systemic immune-inflammation index; SIRI, systemic inflammation response index; AISI, aggregate index of systemic inflammation.

Table 3 The Regression Model for the Prediction of ACS in Patients with and without DM/preDM

	Variable	Category	B	S.E. B	Wald	p-value	Odds Ratio (95% CI)
No DM/preDM	BMI	–	−0.100	0.038	6.875	0.009	0.905 (0.840–0.975)
	Previous MI	Yes	0.648	0.309	4.405	0.036	1.913 (1.044–3.504)
	HDL	–	−0.066	0.013	24.627	<0.001	0.936 (0.912–0.961)
	TG	–	−0.009	0.003	8.227	0.004	0.991 (0.985–0.997)
	Const.	–	6.856	1.463	21.968	<0.001	949.815
	Nagelkerke R^2 = 0.23; χ^2 = 43.3, p < 0.001; Hosmer–Lemeshow goodness of fit χ^2 = 6.823, p = 0.556; AUC = 0.728; YI = 0.390 for cut-off value = 0.484.
DM/preDM	HDL	–	−0.052	0.019	7.259	0.007	0.949 (0.914–0.986)
	LDL	–	0.016	0.006	8.371	0.004	1.016 (1.005–1.028)
	SII	–	0.002	0.001	5.352	0.021	1.002 (1.000−1.003)
	Const.	–	−0.660	0.924	0.510	0.475	0.517
	Nagelkerke R^2 = 0.18; χ^2 = 17.9, p < 0.001; Hosmer–Lemeshow goodness of fit χ^2 = 15.221, p = 0.055; AUC = 0.688; YI = 0.383 for cut-off value = 0.395.