Lymphocyte-based inflammatory markers: Novel predictors of significant coronary artery disease✰,✰✰

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2024-11-15 DOI:10.1016/j.hrtlng.2024.11.006

Dania A. Bani Hani RN, MSN, PhD , Jafar A. Alshraideh PhD , Akram Saleh MD, FRCP , Hamza Alduraidi PhD, MPH, RN , Abeer A. Alwahadneh RN, PhD (c) , Salah S. Al-Zaiti PhD

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引用次数: 0

Abstract

Background

Lymphocyte-based inflammatory indices such as monocyte-to-lymphocyte ratio (MLR) have long been recognized as reliable coronary artery disease (CAD) predictors. More recently, novel indices like the Systemic Inflammatory Index (SII), Systemic Inflammatory Response Index (SIRI), and Systemic Immune-Inflammation Index (SIIRI) have emerged. These newer markers offer a more comprehensive assessment of inflammation by integrating multiple immune cell types, potentially enhancing the prediction of cardiovascular outcomes.

Objectives

We evaluated the predictive value of novel inflammatory markers in estimating the pretest probability of severe CAD in high-risk patients.

Methods

We enrolled consecutive patients undergoing diagnostic coronary angiography in a single tertiary care hospital. Inflammatory markers were calculated based on pre-procedural complete blood count laboratory measurements. Severe CAD was defined as critical (>70 %) and actionable narrowing of a primary coronary artery. Classification performance was assessed using multivariate logistic regression.

Results

The study sample included 363 patients (age 58.9± 11 years, 44.9 % females, 30 % severe CAD). In univariate analysis, MLR, SIRI, and SIIRI were significant predictors of severe CAD, with age- and sex-adjusted OR of 1.98 [1.25–3.14], 1.79 [1.24–2.59], and 1.63 [1.11–2.38], respectively. In multivariate analysis, SIRI remained an independent predictor of severe CAD (OR = 1.98, 95 % CI 1.13–3.46, p = 0.02).

Conclusion

Our results suggest that novel inflammatory markers derived from routine blood tests are predictive of severe CAD in high-risk patients. Such simple, practical, and cost-effective inflammatory markers may enhance cardiac risk stratification and prediction of severe CAD.

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基于淋巴细胞的炎症标志物：重大冠状动脉疾病的新预测指标✰,✰✰。

背景：单核细胞与淋巴细胞比值（MLR）等基于淋巴细胞的炎症指数一直被认为是可靠的冠状动脉疾病（CAD）预测指标。最近，又出现了系统炎症指数（SII）、系统炎症反应指数（SIRI）和系统免疫炎症指数（SIIRI）等新型指数。这些较新的标记物综合了多种免疫细胞类型，可对炎症进行更全面的评估，从而有可能提高对心血管预后的预测能力：我们评估了新型炎症标记物在估计高危患者重度 CAD 检测前概率方面的预测价值：方法：我们在一家三级医院连续招募了接受冠状动脉造影诊断的患者。根据术前全血细胞计数实验室测量结果计算炎症标志物。严重的冠状动脉粥样硬化被定义为主要冠状动脉的严重（>70%）和可采取行动的狭窄。采用多变量逻辑回归对分类效果进行评估：研究样本包括 363 名患者（年龄为 58.9±11 岁，44.9% 为女性，30% 为严重 CAD）。在单变量分析中，MLR、SIRI 和 SIIRI 是严重 CAD 的重要预测指标，经年龄和性别调整后的 OR 分别为 1.98 [1.25-3.14]、1.79 [1.24-2.59] 和 1.63 [1.11-2.38]。在多变量分析中，SIRI 仍是严重 CAD 的独立预测因子（OR = 1.98，95 % CI 1.13-3.46，p = 0.02）：我们的研究结果表明，从常规血液检测中提取的新型炎症标志物可预测高危患者的严重 CAD。这些简单、实用、经济的炎症标记物可能会提高心脏风险分层和严重的冠状动脉粥样硬化的预测能力。

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

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.