Evaluation of the Systemic Immune-Inflammatory Index (SII) and NAPLES Score (NS) in Patients with Non-ST-Elevation Myocardial Infarction (NSTEMI)

Abstract

Objective: Non-ST elevation myocardial infarction (NSTEMI) is the most common type of acute coronary syndrome and has a poor prognosis. The SII and NS are derived from blood cell counts and reflects the balance between inherited and acquired immunity and the association between the immune system and endothelial dysfunction. This study aimed to compare the prognostic value of two novel inflammatory biomarkers, the systemic immune-inflammatory index (SII) and the Naples score (NS), with that of other inflammatory markers and risk scores in patients with NSTEMI. Methods: This was a retrospective cohort analysis of 50 NSTEMI patients and 50 controls matched by age and sex who were admitted to our hospital. We calculated the SII and NS scores and other ratios, indices, and risk scores for each patient. We used Pearson’s correlation coefficient and receiver operating characteristic (ROC) analysis to examine the correlations and predictive values of the SII index, NS score, and other biometric markers and risk scores. Results: The SII and NS were significantly greater in the NSTEMI group than in the control group. They had strong positive correlations with the NLR, MHR, PLR, and TC/HDL ratio, and moderate positive correlations with TIMI and HEART scores (r>0.3, p<0.01 for both). The SII and NS also had higher AUC values than other biometric markers and risk scores (p<0.05 for both). Conclusions: The SII and NS are inexpensive, widely available and easy to measure markers that may have utility for cardiac risk stratification in NSTEMI patients.

Keywords

• Non ST-elevation myocardial infarction
• NAPLES Score
• Systemic immune-inflammatory index
• Novel inflammatory biomarkers

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