Predictive Value of the Systemic Immune-Inflammation Index for Cardiovascular Events in Patients With Chronic Total Coronary Occlusion.

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2026-09-18 eCollection Date: 2026-09-01 DOI:10.31083/RCM52837

Yuhao Zhao, Ping Wang, Shun Zhao, Qin Ma, Ze Zheng, Yuchen Shi, Jinghua Liu

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Abstract

Background: This large-scale cohort study aimed to evaluate the prognostic role of the systemic immune-inflammation index (SII) in patients with chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI).

Methods: A total of 3107 patients with CTO lesions who underwent PCI were enrolled in this study. Clinical characteristics were collected, and post-discharge major adverse cardiovascular events (MACEs) were recorded during follow-up, including all-cause mortality, non-fatal myocardial infarction, unplanned revascularization, and heart failure-related readmission. Patients were stratified into three groups according to SII tertiles: the low SII group (SII ≤447.66, n = 1036), the intermediate SII group (447.66 < SII < 679.89, n = 1039), and the high SII group (SII ≥679.89, n = 1032).

Results: Over a median follow-up of 2.58 (2.33-2.92) years, 356 (11.5%) MACEs occurred, including 49 (1.6%) all-cause deaths, 105 (3.4%) non-fatal myocardial infarctions, 164 (5.3%) revascularizations, and 38 (1.2%) heart failure rehospitalizations. Multivariable Cox regression analyses demonstrated that elevated SII was independently linked to higher risks of MACEs (hazard ratio [HR] = 1.51, 95% confidence interval [CI]: 1.20-1.90; p = 0.001), all-cause death (HR = 2.06, 95% CI: 1.11-3.84; p = 0.022), non-fatal myocardial infarction (HR = 1.76, 95% CI: 1.15-2.69; p = 0.009), and repeat revascularization (HR = 1.32, 95% CI: 1.01-1.76; p = 0.046) after full adjustment. Kaplan-Meier survival curves showed significantly higher rates of adverse events in patients with elevated SII. Adding SII to traditional risk models improved predictive performance, as reflected by increases in the concordance index (C-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Conclusions: Baseline SII is a reliable and independent predictor of MACEs in patients with CTO after PCI, with superior predictive performance compared with conventional inflammatory markers.

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系统性免疫炎症指数对慢性冠脉全闭塞患者心血管事件的预测价值。

背景：本大规模队列研究旨在评估全身免疫炎症指数（SII）在慢性全闭塞（CTO）患者经皮冠状动脉介入治疗（PCI）中的预后作用。方法：本研究共纳入3107例行PCI的CTO病变患者。收集临床特征，随访期间记录出院后主要不良心血管事件（mace），包括全因死亡率、非致死性心肌梗死、计划外血运重建术和心力衰竭相关再入院。根据SII分位数将患者分为低SII组（SII≤447.66,n = 1036）、中SII组（447.66 < SII < 679.89, n = 1039）、高SII组（SII≥679.89,n = 1032）。结果：中位随访2.58（2.33-2.92）年，发生356例（11.5%）mace，包括49例（1.6%）全因死亡，105例（3.4%）非致死性心肌梗死，164例（5.3%）血运重建，38例（1.2%）心力衰竭再住院。多变量Cox回归分析显示，SII升高与完全校正后mace（风险比[HR] = 1.51, 95%可信区间[CI]: 1.20-1.90, p = 0.001）、全因死亡（HR = 2.06, 95% CI: 1.11-3.84, p = 0.022）、非致死性心肌梗死（HR = 1.76, 95% CI: 1.15-2.69, p = 0.009）和重复血运重成术（HR = 1.32, 95% CI: 1.01-1.76, p = 0.046）的高风险独立相关。Kaplan-Meier生存曲线显示SII升高的患者不良事件发生率显著升高。将SII添加到传统风险模型中可以提高预测性能，这反映在一致性指数（C-index）、净重分类改善（NRI）和综合区分改善（IDI）的增加上。结论：基线SII是PCI术后CTO患者mace的可靠且独立的预测指标，与传统炎症标志物相比具有更好的预测性能。

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

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.