Systemic Immune-Inflammation Index Predicts Long-Term Outcomes in Patients with Three-Vessel Coronary Disease After Revascularization: Results from a Large Cohort of 3561 Patients

Abstract

This study aimed to investigate the prognostic value of systemic immune inflammation index (SII) concerning long-term outcomes in patients with the three-vessel disease (TVD) after revascularization in a large cohort. Methods: In total, 3561 TVD patients who had undergone revascularization between 2013 and 2018 were included in the study. Patients were divided into the low SII (<694.3 × 10 9 /L) (n = 2556, 71.8%) and the high SII (≥694.3 × 10 9 /L) group (n = 1005, 28.2%). The C-index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to assess whether the addition of SII to a baseline model with traditional risk factors improved the accuracy of cardiac event prediction. The primary outcome was the frequency of major adverse and cerebrovascular events (MACCE). The secondary outcome was the incidence of all-cause death. Results: After 2.4 years of follow-up, the Cox proportional hazard regression model analysis displayed that high SII was independently associated with an increased risk of developing future MACCE (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.23-2.21, p = 0.001) and all-cause death (HR: 2.96; 95% CI: 1.19-7.32, p = 0.019). The addition of SII significantly improved the reclassification beyond the baseline model with traditional risk factors (MACCE: NRI, 0.115; p = 0.0001; all-cause death: NRI, 0.369; p = 0.0001). Reclassification with the addition of SII also demonstrated an IDI of 0.0022 (p = 0.006) in MACCE and 0.0033 (p = 0.014) in all-cause death. Conclusion:In TVD patients after revascularization, increased SII is an independent prognostic factor for long-term outcomes of MACCE and death. Compared to traditional risk factors, SII improved the risk prediction of major cardiovascular events in TVD patients who underwent revascularization.

Significance of Multiple Lymphocyte-to-C-Reactive Protein Ratios in Predicting Long-Term Major Cardiovascular Adverse Events in Emergency Percutaneous Coronary Intervention Patients with ST-Segment Elevation Myocardial Infarction

“…These conventional cardiovascular risk factors have all been confirmed as contributors to the occurrence of MACEs. 10,14,[22][23][24][25][26][27] While there are limited studies on LCR as a relatively new biomarker for predicting MACEs, our research affirms that the LCR 24 hours post-PCI is associated with traditional cardiovascular risk factors and consistently predicts long-term MACEs.…”

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

“…Table 1 presents a comprehensive overview of the detailed characteristics of the studies incorporated in the meta‐analyses 10,20–27 . Among the selected studies, six were conducted in Asia, while three were conducted in Europe.…”

“…Table 1 presents a comprehensive overview of the detailed characteristics of the studies incorporated in the metaanalyses. 10,[20][21][22][23][24][25][26][27] Among the selected studies, six were conducted in Asia, while three were conducted in Europe. The participants encompassed in this study were individuals diagnosed with either ACS or those who underwent revascularization procedures.…”

The Combined Effect of Systemic Immune-Inflammation Index and Type 2 Diabetes Mellitus on the Prognosis of Patients Undergoing Percutaneous Coronary Intervention: A Large-Scale Cohort Study

“… 29 In a study including 3,561 three-vessel disease patients, SII was a useful predictive tool for worse clinical outcomes after adjusting for potential confounders. 13 As for patients with ST-segment elevation myocardial infarction, several studies suggested that SII could serve as a predictor for in-hospital malignant ventricular arrhythmias, no-reflow phenomenon, and short-term mortality after primary PCI. 12 , 30 A recent prospective study proved that SII was closely associated with all-cause death and cardiovascular death in a general population with no history of cardiovascular diseases through a 20-year follow-up.…”

“… 10 , 11 Furthermore, SII has been identified as an independent predictor for poor clinical outcomes in patients with either stable CAD or acute coronary syndrome (ACS). 12 , 13 …”