Prognostic impact of systemic immune-inflammation index (SII) on infarct size and clinical outcomes in patients with ST-segment elevation myocardial infarction
Ya-li Zhu , Lai Wei , Xu Wang , Yong Zhou , Jun Pu
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Abstract
Background
Systemic immune-inflammation index (SII), calculated as platelet count × neutrophil count/lymphocyte count, is a novel and easily accessible inflammatory marker. Its prognostic value in predicting infarct size and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) remains to be fully explored.
Methods
We analyzed 421 patients who underwent primary percutaneous coronary intervention (PCI) within 12 h of symptom onset, enrolled in a prospective multicenter registry (NCT03768453).All patients received immediate admission blood tests for SII calculation (platelet × neutrophil/lymphocyte counts) and completed standardized CMR imaging within 10 days post-PCI.Receiver operating characteristic (ROC) analysis identified the optimal SII cut-off value (914) to predict large infarct size (≥20 % of left ventricular mass). Patients were stratified into high (≥914) and low (<914) SII groups. The relationships between SII, infarct size, and MACE were analyzed using multivariate logistic and Cox regression models.
Results
Patients with high SII had significantly larger infarct size (median 29.0 % vs. 22.3 %, p < 0.001). SII ≥ 914 was independently associated with large infarct size (OR 1.889, 95 %CI: 1.100–3.242, p = 0.021) and higher incidence of MACE (HR 1.874, 95 % CI: 1.255–2.796, p = 0.002).
Conclusions
Elevated SII (≥914) independently associates with larger infarct size and increased MACE risk post-PCI, suggesting potential utility in risk stratification.
期刊介绍:
IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.