The predictive role of systemic immune-inflammation index in non-ischemic cardiomyopathy

Year 2024, , 36 - 41, 29.02.2024

Murat Oğuz Özilhan , Gökhan Gökalp

https://doi.org/10.47582/jompac.1421111

Abstract

Aims: The systemic immune-inflammation index (SII), a useful marker of systemic inflammation, has been shown to be associated with cardiovascular diseases in previous studies. Inflammation is known to have a significant role in heart failure, but no study has evaluated the relationship between inflammatory parameters and prognosis in patients with non-ischemic cardiomyopathy (NICM). This study aimed to explore the relationship between SII and long-term mortality in patients with non-ischemic cardiomyopathy.
Methods: The study enrolled 326 consecutive patients with NICM. The median 25-month follow-up mortality results of the patients were recorded retrospectively. SII, a combined index based on the count of three parameters, was calculated as follows: neutrophil count x platelet count/lymphocyte count. Patients with a higher SII value than the median SII were accepted as having a high SII, and the remaining patients were defined as having a low SII. The survival curves of the patients with high and low SII values during the study period were analyzed using the Kaplan-Meier method.
Results: The mean age of the participants was 46.6 years. The mean SII value was 598.4 in patients without mortality and 722.7 in those with mortality. In the multivariate logistic regression analysis, SII was found to be an independent predictor of mortality. The median SII value of the patients who participated in the study was 644. Upon dividing the patients into two groups according to the median SII value, the mortality rate was determined to be 48.4% in the high SII group and 27.4% in the low SII group.
Conclusion: High SII values were observed to be associated with long-term mortality in patients with NICM. SII, which is easily accessed and simply calculated, can be used to predict mortality risk in these patients. Prospective and larger cohort studies are needed to clarify the causality of this relationship.

Keywords

Heart failure, non-ischemic cardiomyopathy, systemic immune-inflammation index

İskemik olmayan kardiyomiyopatili hastalarda sistemik inflamasyon mortaliteyi öngördürür mü?

Abstract

Amaç: Sistemik inflamasyonun yararlı bir belirteci olan sistemik immün-inflamatuvar indeks (SII) kardiyovasküler hastalıklarla ilişkilidir. İnflamasyonun kalp yetersizliği ile takipli hastalarda önemli bir rolü olduğu bilinmektedir. Bununla birlikte iskemik olmayan kardiyomiyopati (NİKMP) hastalarında inflamatuvar parametreler ile prognoz arasındaki ilişkiyi değerlendiren bir çalışma bulunmamaktadır. Bizim çalışmamız, iskemik olmayan kardiyomiyopatili hastalarda SII ile uzun dönem mortalite arasındaki ilişkiyi araştırmayı amaçlamaktadır.
Gereç ve Yöntem: NIKMP ile takipli 326 ardışık hasta çalışmaya dahil edilmiştir. Hastaların medyan takip süresi 25 aydır. Bu süreçte ölüm verileri retrospektif olarak kaydedilmiştir. Sistemik immün inflamasyon indeksi, nötrofil, trombosit ve lenfosit olmak üzere üç parametrenin sayımına dayanan kombine bir indekstir. SII, nötrofil sayısı x trombosit sayısı/lenfosit sayısı şeklinde hesaplanmıştır.
Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 46.6 ‘dır. Ortalama SII değeri takip süresince mortalite yaşanmayan hastalarda 598.4, mortalite yaşanan hastalarda ise 722.7 olarak hesaplanmıştır. Çok değişkenli lojistik regresyon analizinde, SII ' nin mortalitenin bağımsız bir öngörücüsü olduğu bulunmuştur. Çalışmaya katılan hastaların medyan SII değeri 644 idi. Hastalar medyan SII değerine göre yüksek SII ve düşük SII olarak iki gruba ayrıldığında, mortalite oranı yüksek SII grubunda %48.4, düşük SII grubunda ise %27.4 olarak saptanmıştır.
Sonuç: NIKMP ile takipli hastalarda yüksek SII değerinin uzun dönem mortalite ile ilişkili olduğu gösterilmiştir. Bu hasta grubunda kolay ulaşılan ve basitçe hesaplanabilen SII, mortalite riskini tahmin etmede kullanılabilir. Prospektif ve daha geniş hasta grupları ile yapılan çalışmalarla bu ilişkinin nedenselliğini açıklamaya ihtiyaç vardır.

Keywords

kalp yetersizliği, iskemik olmayan kardiyomiyopati, sistemik immün-inflamasyon indeksi

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