The Association Between Systemic Immune Inflammation Index and Intermediate-Term Mortality in Patients with Acute Coronary Syndromes

Abstract

Background: ic immune inflammation has been investigated as a prognostic marker for different disea-ses. Considering the pivotal role of inflammation in the pathogenesis of acute coronary syndrome (ACS), it is paramount to predict the prognosis of patients with ACS. Therefore, we evaluated the association between inflammation measured by the systemic immune-inflammation index (SII) and middle-term mortality in patients with ACS. Materials and Methods: This single-center, retrospective study was composed of 539 patients with ACS (139 unstable angina pectoris [USAP], 165 non-ST-elevation myocardial infarction [NSTEMI], and 235 ST-elevation myocardial infarction [STEMI]) aged over 18 years. Descriptive statistics and multivari-ate regressions were used to examine the association between clinical and laboratory parameter characteristics and 12-month mortality. Results: The median age of the patients was 58 (50-67) and 73.1% of the patients were male. A total of 20 patients died in the next twelve months after ACS event. The median SII levels were highest in patients with STEMI [1301.96 (816.81-2174.53)] , followed by NSTEMI [955.50 (619.99-1576-06] and USAP [595.32 (437.52-918.27)] (p<0.001). The SII had moderate success for the prediction of the intermediate-term mortality (AUC: 0.653, 95% CI: 0.526-0.779, p=0.024). In multivariate analyses, every 100-unit increase in SII was associated with a two percent increase in the risk of intermediate mortality (OR: 1.020, 95% CI: 1.004-1.037, p=0.016). Conclusions: We demonstrated that ACS patients with higher SII levels had a higher risk of mortality at twelve months, and higher SII levels were associated with a more severe underlying ACS etiology. If supported by prospective evidence, the SII index may guide clinicians in terms of both ACS severity and subsequent one-year survival rates.

Keywords

• acute coronary syndrome
• systemic immune-inflammation index
• mortality
• prognosis
• inflammation

Akut Koroner Sendromlu Hastalarda Sistemik İmmün İnflamasyon İndeksi ile Orta Dönem Mortalite Arasındaki İlişki

Abstract

Amaç: Sistemik immün inflamasyon farklı hastalıklar için prognostik bir belirteç olarak araştırılmıştır. Akut koroner sendrom (AKS) patogenezinde inflamatuar basıncın önemli rolü göz önüne alındığında, AKS'li hastaların prognozunu tahmin etmek çok önemlidir. Bu nedenle, AKS hastalarında sistemik immün-inflamasyon indeksi (SII) ile ölçülen inflamatuar basınç ile orta dönem mortalite arasındaki ilişkiyi değerlendirdik. Materyal ve Metod: Bu tek merkezli, retrospektif çalışmaya 18 yaş üstü 539 AKS hastası (139 USAP, 165 NSTEMI ve 235 STEMI) dahil edildi. Klinik ve laboratuvar parametre özellikleri ile 12 aylık mortalite arasındaki ilişkiyi incelemek için tanımlayıcı istatistikler ve çok değişkenli regresyonlar kullanıldı. Bulgular: Hastaların ortanca yaşı 58 (IQR 50-67) idi ve hastaların %73,1'i erkekti. Toplam 20 hasta AKS olayından sonraki on iki ay içinde hayatını kaybetti. Ortanca SII düzeyleri STEMI (1301,96) hastalarında en yüksekti, bunu NSTEMI (955,50) ve USAP (595,32) izledi (p<0,001). SII, orta vadeli mortalitenin öngörülmesinde orta derecede başarılı olmuştur (AUC: 0,653, %95 GA: 0,526-0,779, p=0,024). Çok değişkenli analizlerde, SII'deki her 100 birimlik artış orta dönem mortalite riskinde yüzde iki artışla ilişkilendirilmiştir (HR: 1.020, %95 GA: 1.005-1.036, p=0.011). Sonuç: Daha yüksek SII düzeylerine sahip AKS hastalarının on iki ayda daha yüksek mortalite riskine sahip olduğunu ve daha yüksek SII düzeylerinin altta yatan daha ciddi AKS etiyolojisi ile ilişkili olduğunu gösterdik. İleriye dönük kanıtlarla desteklenirse, SII indeksi hem AKS şiddeti hem de sonraki bir yıllık sağkalım oranları açısından klinisyenlere yol gösterebilir.

Keywords

• akut koroner sendrom
• sistemik immün-inflamasyon indeksi
• mortalite
• prognoz
• inflamasyon

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