Systemic immune inflammatory response index (SIIRI) in acute myocardial infarction.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2024-11-06 DOI:10.1097/MCA.0000000000001454

Ghazi Muheeb, Jamal Yusuf, Vimal Mehta, Md Faizuddin, Sumod Kurian, Girish M P, Mohit Dayal Gupta, Safal Safal, Ankur Gautam, Narendra Kumar Chauhan

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引用次数: 0

Abstract

Background: Different treatment approaches exist for non-ST elevation acute coronary syndrome (ACS) patients. This study assessed the systemic immune inflammatory response index (SIIRI) for its prognostic value and incremental clinical utility in determining optimal timing for percutaneous coronary intervention (PCI) in non-ST elevation myocardial infarction (NSTEMI) patients, particularly when troponin levels are initially negative.

Methods: This study included 1270 ACS patients: 437 STEMI, 422 NSTEMI, and 411 unstable angina. Patients were stratified by SIIRI levels measured at admission, and coronary artery disease severity was evaluated using the SYNTAX score. The primary endpoint was major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, stroke, and revascularization. Secondary endpoints encompassed individual MACE components and heart failure hospitalisations.

Results: The mean age was 54.93 years (83% male). SIIRI levels were significantly higher in STEMI patients (6.83 ± 6.43 × 105) compared to NSTEMI (4.5 ± 5.39 × 105) and unstable angina (3.48 ± 2.83 × 105) (P < 0.001). Area under the curve for SIIRI distinguished NSTEMI and unstable angina from STEMI (0.81 and 0.80), with optimal cut-off points of 4.80 × 105 and 4.25 × 105. In NSTEMI, 24.6% presented within 2 h of symptom onset, were troponin-negative, yet had elevated SIIRI. Post-PCI, SIIRI > 4.93 × 105 correlated with increased MACE at 1 year (17.2% vs 5%).

Conclusion: NSTEMI and unstable angina patients with SIIRI values >4.80 × 105 and 4.25 × 105 respectively, may require urgent intervention (<2 h). SIIRI can be of significant utility in patients of NSTEMI who present earlier with negative troponins. SIIRI can also aid in identifying high-risk individuals post-PCI, providing a valuable tool for early and accurate assessment.

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急性心肌梗死的全身免疫炎症反应指数（SIIRI）。

背景：针对非ST段抬高的急性冠脉综合征（ACS）患者存在不同的治疗方法。本研究评估了全身免疫炎症反应指数（SIIRI）在确定非 ST 段抬高型心肌梗死（NSTEMI）患者经皮冠状动脉介入治疗（PCI）最佳时机方面的预后价值和增量临床效用，尤其是当肌钙蛋白水平最初为阴性时：本研究纳入了 1270 名 ACS 患者：437例STEMI患者、422例NSTEMI患者和411例不稳定型心绞痛患者。根据入院时测得的 SIIRI 水平对患者进行分层，并使用 SYNTAX 评分评估冠状动脉疾病的严重程度。主要终点是主要不良心血管事件（MACE），包括心血管死亡、非致死性心肌梗死、中风和血管再通。次要终点包括MACE的各个组成部分和心衰住院次数：平均年龄为 54.93 岁（83% 为男性）。STEMI 患者的 SIIRI 水平（6.83 ± 6.43 × 105）明显高于 NSTEMI（4.5 ± 5.39 × 105）和不稳定型心绞痛患者（3.48 ± 2.83 × 105）（P 4.93 × 105），且 1 年后 MACE 增加（17.2% vs 5%）：结论：SIIRI 值分别大于 4.80 × 105 和 4.25 × 105 的 NSTEMI 和不稳定型心绞痛患者可能需要紧急干预（P＜0.05）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.