{"title":"Systemic immune-inflammation index as a predictor of statin residual cardiovascular risk compared with C-reactive protein","authors":"Yihua Lu , Meng Wei , Kandi Zhang , Peng Zhang , Dongsheng Liu , Zheyi Jiang , Tiantian Zhang , Junfeng Zhang","doi":"10.1016/j.ijcard.2025.133529","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Despite statins reducing cardiovascular (CV) disease risk, residual inflammatory risk persists in treated patients. The systemic immune-inflammation index (SII), integrating platelet, neutrophil, and lymphocyte counts, has emerged as a novel biomarker of systemic inflammation and immune dysregulation. This study evaluated the systemic immune-inflammation index (SII) as a predictor of residual CV mortality compared to C-reactive protein (CRP) in statin users.</div></div><div><h3>Method</h3><div>This study included 8211 adults with statin use from the National Health and Nutritional Examination Surveys (NHANES) 1999–2018 and were followed for survival through December 31, 2019. Cox proportional hazard models were used to investigate the associations between natural log-transformed SII (lnSII) and cardiovascular mortality. Predictive accuracy was compared via receiver operating characteristic (ROC) curves.</div></div><div><h3>Result</h3><div>During the follow-up period of 6.92 (3.75, 11) years, a total of 2261 all-cause deaths and 796 cardiovascular deaths were recorded. After adjusting for covariates, higher baseline SII was significantly associated with an elevated risk of CV mortality (hazard ratio [HR] for per unit increase in natural log-transformed SII (lnSII), 1.241; 95 % confidence interval [CI], 1.009–1.527). The ROC curve analysis demonstrated SII's superior predictive accuracy (AUC, 0.760; 95 %CI, 0.744–0.776) over CRP (AUC, 0.749; 95 % CI, 0.733–0.765).</div></div><div><h3>Conclusion</h3><div>Among patients receiving contemporary statins, SII was shown to be an independent predictor of future CV death. SII outperformed CRP as an inflammatory biomarker for residual CV risk in statin-treated patients.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"438 ","pages":"Article 133529"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167527325005728","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Despite statins reducing cardiovascular (CV) disease risk, residual inflammatory risk persists in treated patients. The systemic immune-inflammation index (SII), integrating platelet, neutrophil, and lymphocyte counts, has emerged as a novel biomarker of systemic inflammation and immune dysregulation. This study evaluated the systemic immune-inflammation index (SII) as a predictor of residual CV mortality compared to C-reactive protein (CRP) in statin users.
Method
This study included 8211 adults with statin use from the National Health and Nutritional Examination Surveys (NHANES) 1999–2018 and were followed for survival through December 31, 2019. Cox proportional hazard models were used to investigate the associations between natural log-transformed SII (lnSII) and cardiovascular mortality. Predictive accuracy was compared via receiver operating characteristic (ROC) curves.
Result
During the follow-up period of 6.92 (3.75, 11) years, a total of 2261 all-cause deaths and 796 cardiovascular deaths were recorded. After adjusting for covariates, higher baseline SII was significantly associated with an elevated risk of CV mortality (hazard ratio [HR] for per unit increase in natural log-transformed SII (lnSII), 1.241; 95 % confidence interval [CI], 1.009–1.527). The ROC curve analysis demonstrated SII's superior predictive accuracy (AUC, 0.760; 95 %CI, 0.744–0.776) over CRP (AUC, 0.749; 95 % CI, 0.733–0.765).
Conclusion
Among patients receiving contemporary statins, SII was shown to be an independent predictor of future CV death. SII outperformed CRP as an inflammatory biomarker for residual CV risk in statin-treated patients.
期刊介绍:
The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers.
In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.