Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: A systematic review and meta-analysis

Abstract

BackgroundSeveral studies have investigated the value of the systemic immune-inflammation index (SII) for predicting cardiovascular disease (CVD), but the results were inconsistent. Therefore, a meta-analysis and systematic review were conducted to assess the correlation between SII and risk of CVD.Materials and methodsTwo investigators systematically searched PubMed, Embase, Web of Science, Cochrane library, and CINAHL databases to identify all studies that examined the association between SII levels and CVD. The risk estimates of CVD for people with high SII compared to those with low SII levels and the weighted mean difference (WMD) between the CVD and control groups were pooled using fixed- or random-effects models based on the heterogeneity test. We used the Newcastle-Ottawa Scale to assess the risk of bias in eligible studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to rate the certainty of evidence.ResultsA total of 13 studies with 152,996 participants were included for analysis. The overall pooled results showed that higher SII was significantly associated with an increased risk of CVD (HR = 1.39, 95%CI: 1.20–1.61, P < 0.001). This increased risk could be observed in almost all CVD subtypes, including ischemic stroke (HR = 1.31, 95%CI: 1.06–1.63, P = 0.013), hemorrhagic stroke (HR = 1.22, 95%CI: 1.10–1.37, P < 0.001), myocardial infarction (HR = 1.11, 95%CI: 1.01–1.23, P = 0.027), and peripheral arterial disease (HR = 1.51, 95%CI: 1.18–1.93, P = 0.001). There were no significant but still similar trends in venous thrombosis (HR = 4.65, 95%CI: 0.66–32.71, P = 0.122), cerebral small vessel disease (HR = 1.09, 95%CI: 0.95–1.25, P = 0.233), and acute coronary syndrome (HR = 1.08, 95%CI: 0.96–1.22, P = 0.200). Furthermore, the pooled results showed that SII levels at the onset of CVD were significantly higher than that in the general population (WMD = 355.2, 95%CI: 234.8–475.6, P < 0.001), which was consistent across different CVD subtypes. The GRADE assessment suggested that the quality of current evidence from observational studies was low or very low.ConclusionThis study indicated that SII may be a potential biomarker for CVD development and elevated SII is associated with an increased risk of CVD. However, the quality of evidence is generally low. Additional well-designed studies are necessary to determine the optimal cutoff value and to characterize the benefited population.

Systemic Immune Inflammatory Index Is Associated with Pustular Psoriasis: A Single Center Retrospective Study

“…When determined by other comorbidities, a significant relationship was noted between SII and hypertension in p. pustular patients (p < 0.05), while smoking, diabetes and others were non-significant. This result is consistent with previous studies that demonstrated association between psoriasis and cardiovascular diseases [26] [27], however, it is the first study to show an association between SII and a cardiovascular disease in p. pustular as a subtype of psoriasis. Looking at our study as a whole, there appears to be a relationship between SII and p. pustular whereas no relationship exists with p. vulgaris and p. erythroderma.…”

Association of Systemic Immune Inflammation Index with Estimated Pulse Wave Velocity, Atherogenic Index of Plasma, Triglyceride-Glucose Index, and Cardiovascular Disease: A Large Cross-Sectional Study

“…This may be due to differences in the population and suggests that the changing trend of blood lipids is different in different inflammatory diseases. In recent years, many studies have confirmed the predictive efficacy of the SII index in cardiovascular disease [34][35][36][37][38], and a recent meta-analysis also showed that people with high SII index levels have a significantly increased risk of CVD [39]. The SII index value also increased significantly at different CVD initiations.…”

“…In recent years, many studies have confirmed the predictive efficacy of the SII index in cardiovascular disease [ 34 – 38 ], and a recent meta-analysis also showed that people with high SII index levels have a significantly increased risk of CVD [ 39 ]. The SII index value also increased significantly at different CVD initiations.…”

Association of systemic immune inflammatory index with all-cause and cause-specific mortality in hypertensive individuals: Results from NHANES

“…SII is considered to be able to comprehensively evaluate the level of immunity and inflammation status. In a meta-analysis involving 152,996 patients, higher SII was associated with an increased risk of nearly all CVD subtypes, including myocardial infarction, ischemic or hemorrhagic stroke, and peripheral arterial disease ( 27 ). Basic research has also confirmed the involvement of SII components in hypertension.…”