Development of a Novel Inflammatory Index to Predict Coronary Artery Disease Severity in Patients With Acute Coronary Syndrome

Abstract

The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have previously demonstrated predictive value in coronary artery disease (CAD). We developed on an expanded, novel systemic immune-inflammation response index (SIIRI), calculated as peripheral neutrophil × monocyte × platelet ÷ lymphocyte count. We assessed 240 patients with an acute coronary syndrome that subsequently underwent percutaneous coronary intervention. CAD severity was measured using the SYNTAX score. Laboratory measurements, including cell counts, were obtained on admission. On multivariate analysis, the SIIRI was an independent predictor of severe CAD with an adjusted odds ratio (OR) of 1.666 [1.376-2.017] per 105-unit increase. The SIIRI had the highest area under the receiver operator curve of .771 [.709-.833] compared to the SII, SIRI neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio. The optimal cut-off for SIIRI was 4.3 × 105, with sensitivity = 69.9% and specificity = 75.8%. Increment in model performance resulting from adding SIIRI versus other inflammatory indices was assessed using discrimination, calibration, and goodness-of-fit measures. When added to a baseline model, the SIIRI resulted in a significant increase in the c-statistic and significant net reclassification index (.808, P < .0001) and integrated discrimination index (.129, P < .0001), and a decrease in Akaike and Bayesian information criteria.

Pan-Immune-Inflammation Value Could Be a New Marker to Predict Amyloidosis and Disease Severity in Familial Mediterranean Fever

“…PIV is a novel blood-based biomarker encompassing immune cell subpopulations of neutrophils, platelets, monocytes, and lymphocytes in peripheral blood [ 19 ]. PIV has also been studied in various diseases under different names, such as the systemic immune-inflammation response index (SIIRI) and the aggregate index of systemic inflammation (AISI), and has been found to be associated with certain inflammatory conditions [ 32 , 33 ]. Studies on PIV have mainly been conducted in the field of oncology.…”

Prognostic value of systemic immune‐inflammation index in CAD patients: Systematic review and meta‐analyses

“…In addition, from the dimension of clinical events, SII also exhibits a noteworthy connection with some adverse conditions that often lead to unfavourable prognoses. Three studies 36–38 employing distinct methodologies to evaluate the severity of coronary artery lesions all indicated a correlation between elevated SII and more severe coronary artery lesions. Among patients undergoing coronary angiography or PCI, patients with higher SII were more likely to suffer from contrast‐induced nephropathy 39,40 .…”

The Systemic Immune Inflammatory Response Index Can Predict the Clinical Prognosis of Patients with Initially Diagnosed Coronary Artery Disease

“…Its overall predictive effect was better than that of previous inflammatory markers. 6 Similarly, previous inflammatory markers, including NLR, PLR, and MLR, have been shown to be predictive in patients with CAD. 14–20 As proved by various cohort studies and meta-analyses, SII, as a new inflammatory marker composed of three blood cell subtypes, can more comprehensively evaluate the inflammatory status of patients with CAD compared with the inflammatory markers composed of two cell subtypes (NLR, PLR, and MLR).…”

“…However, applying many biomarkers in the clinical setting is challenging due to the high cost and processing time. 6 Developing an ideal indicator that can be easily measured with high precision is vital to predicting the clinical prognosis of patients with CAD.…”