The association between the aggregate index of systemic inflammation and cardiovascular risk in peritoneal dialysis patients.

Background and aim: The aggregate index of systemic inflammation (AISI), a novel inflammatory biomarker, is associated with various diseases. However, its association with cardiovascular risk in patients treated with peritoneal dialysis (PD) remains unclear. This study aims to explore the relationship between AISI and cardiovascular risk in this high-risk population, providing new insights for risk stratification and guiding clinical decision-making.

Methods and results: This retrospective study enrolled 316 patients who underwent PD catheter insertion at the Second Affiliated Hospital of Anhui Medical University between January 1, 2010, and July 31, 2022. The optimal cut-off value of AISI for predicting cardiovascular events (CVE) was 213.58 using ROC curve analysis. Based on this cut-off value, patients were classified into high and low AISI groups. During a median follow-up of 39 (22, 66) months, 110 patients (34.8 %) developed CVE, and 37 patients (11.7 %) experienced cardiovascular mortality. Kaplan-Meier curves showed that the cumulative incidence of CVE (P < 0.001) and cardiovascular mortality (P = 0.002) were significantly higher in the high AISI group. After adjusting for potential confounding factors, a higher AISI remained an independent risk factor for both CVE (hazard ratio: 2.052; 95 % CI: 1.330-3.164; P = 0.001) and cardiovascular mortality (hazard ratio: 2.651; 95 % CI: 1.088-6.455; P = 0.032) in patients treated with PD. Subgroup analyses showed no significant interactions between AISI and the subgroup variables (P for interaction >0.05).

Conclusions: Elevated AISI levels are independently associated with an increased risk of CVE and cardiovascular mortality in patients treated with PD. AISI may have significant implications for clinical practice.