Prognostic value of systemic inflammatory response index in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Abstract

Background The systemic inflammatory response index (SIRI) is a novel inflammatory biomarker in many diseases. Objectives The aim of this study was to examine the association between SIRI and adverse events in patients with the acute coronary syndrome (ACS) undergoing percutaneous coronary intervention. Methods A total of 1724 patients with ACS enrolled from June 2016 to November 2017 at a single centre were included in this study, and SIRI was calculated for each patient. The primary endpoint was the composite of major adverse cardiovascular events (MACE), including overall death, non-fatal myocardial infarction, non-fatal stroke, and unplanned repeat revascularization. Results During a median follow-up of 927 days, 355 patients had MACE. Multivariate Cox analysis showed that SIRI was significantly associated with MACE (hazard ratio: 1.127, 95% confidence interval: 1.034–1.229 p = .007). The results were consistent in multiple sensitivity analyses. The addition of SIRI had an incremental effect on the predictive ability of the Global Registry of Acute Coronary Events risk score for MACE (integrated discrimination improvement: 0.007, p = .040; net reclassification improvement: 0.175, p = .020; likelihood ratio test: p < .001). The restricted cubic spline showed a monotonic increase with a greater SIRI value for MACE ( p < .001). Conclusion SIRI was an independent risk factor for MACE and provided incremental prognostic information in patients with ACS undergoing percutaneous coronary intervention. KEY MESSAGES The SIRI is a strong and independent risk factor for adverse outcomes in patients with ACS undergoing percutaneous coronary intervention. Higher SIRI is associated with a more severe disease status. The SIRI could increase the prognostic value of the GRACE risk score.

Investigation of the Associations of Novel Inflammatory Biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)—With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence

“…In a 10-year observation, SIRI was found to have an association with CVD occurrence [ 41 ] and an increased risk of supraventricular tachycardia in patients with a history of stroke [ 42 ]. In patients who underwent percutaneous coronary intervention (PCI) due to ACS, SIRI was an independent predictor of MACE [ 29 , 43 ].…”

The association between systemic inflammatory response index and new-onset atrial fibrillation in patients with ST-elevated myocardial infarction treated with percutaneous coronary intervention

“…Several inflammatory indexes, such as, C-reactive protein, NLR, interleukins, have been demonstrated to be predictive of short- or long-term prognosis in patients with STEMI [ 24 – 28 ]. Recent studies had demonstrated the positive relationship between SIRI and prognosis information in different subject cohorts [ 14 – 16 , 18 , 29 ]. For instance, Xu et al conducted a multi-center retrospective analysis of 1,499 rheumatoid arthritis (RA) patients, and determined that SIRI is significantly related to the disease activity of RA, even can predict the tumor development of RA individuals [ 29 ].…”

Effect of dapagliflozin on the prognosis of patients with acute myocardial infarction undergoing percutaneous coronary intervention

“…MI was considered as [ 1 ] symptoms of ischemic chest pain; [ 2 ] a characteristic ST-T dynamic evolution on the electrocardiogram, or with abnormal q waves; [ 3 ] serum myocardial enzyme spectrum increased and decreased. Nonfatal MI was diagnosed as new pathological Q waves in ≥ 2 contiguous electrocardiogram leads according to the previous study [ 13 ]. Patients with an acute ischemic cerebral vascular event were diagnosed with stroke, and any nonstaged revascularization after PCI was considered URR (Fig.…”