The Relationship Between Systemic Inflammatory Response Index and Systemic Immune-Inflammation Index and Diagnostic Rates of Myocardial Infarction, Pulmonary Thromboembolism, and Aortic Dissection in Patients Presenting to the Emergency Department with Chest Pain

Yıl 2026, Cilt: 7 Sayı: 1, 91 - 101, 31.01.2026

İsmail Ağı , Can Kerestecioğlu , Ümmühan Tuğba Tümüklü , Selin Büşra Çakır , Zehra Seyfikli

https://doi.org/10.47482/acmr.1826347

Öz

Background: This study aims to investigate the association between the Systemic Inflammatory Response Index (SIRI) and the Systemic Immune-Inflammation Index (SII) and serious cardiovascular diagnoses such as myocardial infarction, pulmonary thromboembolism, and aortic dissection in patients presenting to the emergency department with chest pain. Additionally, it evaluates the potential role of these biomarkers in supporting clinical decision-making processes.
Methods: This retrospective cross-sectional study included 612 patients aged 18–100 years who presented with chest pain to the Emergency Department of Yozgat City Hospital between July 1, 2025, and July 31, 2025. Demographic characteristics, final diagnoses, and laboratory parameters were analyzed, and SII and SIRI values were calculated accordingly. Statistical analyses were conducted using SPSS 22 with appropriate statistical tests.
Results: In the STEMI group, the mean SII was 1725.90 ± 1274.25 and the mean SIRI was 4.50 ± 3.66. In the NSTEMI group, these values were 1410.94 ± 1341.51 and 3.28 ± 2.79, respectively. Patients with non-cardiovascular causes exhibited significantly lower SII and SIRI levels. Based on ROC analysis, the AUC for SII was 0.738 with a cut-off value of 658, while the AUC for SIRI was 0.723 with a cut-off of 1.92. A positive and significant correlation was found between SII/SIRI and troponin and D-dimer levels (p < 0.001).
Conclusion: SII and SIRI levels are markedly elevated in chest pain of cardiovascular origin and may serve as useful adjunct biomarkers in the diagnostic differentiation of these conditions.

Anahtar Kelimeler

Chest Pain , Systemic Inflammatory Response Index (SIRI) , Emergency Department Diagnostic Approach

Etik Beyan

All authors declare that the study was conducted in accordance with the Declaration of Hesinki and followed the ethical standards of Türkiye. Approval was granted by the Yozgat Bozok University Non-Interventional Clinical Research Ethics Committee (2025-GOKAEK- 2518_2025.15.10_687).

Destekleyen Kurum

None

Teşekkür

None

Göğüs Ağrısı Şikâyeti ile Acil Servise Başvuran Hastalarda Sistemik İnflamatuar Yanıt İndeksi ve Sistemik İmmün-İnflamasyon İndeksi ile Miyokard Enfarktüsü, Pulmoner Tromboemboli ve Aort Diseksiyonu Tanı Oranları Arasındaki İlişki

Öz

Amaç: Bu çalışmanın amacı, göğüs ağrısı şikâyetiyle acil servise başvuran hastalarda Sistemik İnflamatuar Yanıt İndeksi (SIRI) ve Sistemik İmmün-İnflamasyon İndeksi (SII) düzeylerinin miyokard enfarktüsü, pulmoner tromboemboli ve aort diseksiyonu gibi ciddi kardiyovasküler tanılarla olan ilişkisini incelemek ve bu biyobelirteçlerin klinik karar destek süreçlerindeki potansiyel rollerini değerlendirmektir.
Gereç ve Yöntem: Retrospektif ve kesitsel olarak yürütülen bu çalışma, 01.07.2025–31.07.2025 tarihleri arasında Yozgat Şehir Hastanesi Acil Servisi'ne göğüs ağrısı şikâyetiyle başvuran 18–100 yaş arası 612 hastayı kapsamaktadır. Hastaların demografik verileri, tanıları ve laboratuvar sonuçları analiz edilerek SII ve SIRI değerleri hesaplanmıştır. Veriler SPSS 22 programı ile analiz edilmiş, uygun istatistiksel testler kullanılmıştır.
Bulgular: STEMI grubunda SII ortalaması 1725,90 ± 1274,25, SIRI ise 4,50 ± 3,66 olarak belirlenmiştir. NSTEMI grubunda bu değerler sırasıyla 1410,94 ± 1341,51 ve 3,28 ± 2,79’dur. Kardiyovasküler dışı nedenlerde SII ve SIRI değerleri anlamlı düzeyde daha düşük bulunmuştur. ROC analizine göre SII için AUC: 0,738 ve cut-off: 658; SIRI için AUC: 0,723 ve cut-off: 1,92 olarak hesaplanmıştır. SII ve SIRI ile Troponin ve D-Dimer düzeyleri arasında pozitif ve anlamlı korelasyon saptanmıştır (p < 0,001).
Sonuç: SII ve SIRI indeksleri, kardiyovasküler kaynaklı göğüs ağrısında anlamlı derecede yüksek olup, tanısal ayrımda yardımcı biyobelirteçler olarak kullanılabilir niteliktedir.

Anahtar Kelimeler

Göğüs Ağrısı , Sistemik İnflamatuar Yanıt İndeksi (SIRI) , Acil Servis Tanı Yaklaşımı

Etik Beyan

Yozgat Bozok Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu onayı 2025-GOKAEK-2518_2025.15.10_687

Destekleyen Kurum

Yok

Teşekkür

Yok

Kaynakça

• Deniz L, Yuksel Y, Arslan HF, Aral H, Bulut U. Evaluation of systemic inflammation markers in predicting cardiac risk in patients with acute chest pain. Int J Med Biochem. 2023;6(2):75-83.
• Wang C, Yan W, Ren M, Zhong L. Screening significance of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) in coronary heart disease of symptomatic youth. Immun Inflamm Dis. 2024;12:e1369.
• Dziedzic EA, Gasior JS, Tuzimek A, Paleczny J, Junka A, Dabrowski M, et al. Investigation of the associations of novel inflammatory biomarkers—systemic inflammatory index (SII) and systemic inflammatory response index (SIRI)—with the severity of coronary artery disease and acute coronary syndrome occurrence. Int J Mol Sci. 2022;23(17):9553.
• Liu Z, Zheng L. Associations between SII, SIRI, and cardiovascular disease in obese individuals: a nationwide cross-sectional analysis. Front Cardiovasc Med. 2024;11:1361088.
• Bayraktar MF, Cosgun M. Can SII and SIRI predict the severity of coronary artery disease? Northwest Med J. 2024;4(3):157-62.
• Li Y, Bai G, Gao Y, Guo Z, Chen X, Liu T, et al. The systemic immune inflammatory response index can predict the clinical prognosis of patients with coronary artery disease. J Inflamm Res. 2023;16:5069-82.
• Guo J, Huang Y, Pang L, Yuan J, Zhou B, Fu M. Association of SIRI with ST segment elevation myocardial infarction and degree of coronary stenosis: a cross-sectional study. BMC Cardiovasc Disord. 2024;24(1):98.
• Xiu J, Lin X, Chen Q, Yu P, Lu J, Yang Y, et al. The aggregate index of systemic inflammation (AISI): a novel predictor for hypertension. Front Cardiovasc Med. 2023;10:1163900.
• Can systemic inflammatory markers be used in pulmonary embolism risk assessment in acute pulmonary thromboembolism? J Inflamm Res. 2023;18:5969-77.
• Haba MSC, Manole OM, Buburuz AM, Tudorancea I, Costache-Enache II, Onofrei V. The prognostic value of inflammatory indices in acute pulmonary embolism. Diagnostics (Basel). 2025;15(3):312.
• Wang Z, Bai J, Li P, Jiao G. Predictive value of SIRI, AISI and SII in diagnosis and risk stratification of acute pulmonary embolism. Acad J Chin PLA Med Sch. 2024;45(1):53-8,66.
• Pengfei C, Lui M, Zhang L, Chen C, Wang T, Ailin H, et al. Association of SII and SIRI with cardiovascular disease in cardiovascular-kidney-metabolic syndrome: a prospective cohort study. Front Nutr. 2025;12:1661826.
• Zheng T, Luo C, Xu S, Li X, Tian G. Association of the systemic immune-inflammation index with clinical outcomes in acute myocardial infarction patients with hypertension. BMC Immunol. 2025;26:10.
• Liu H, Wang P, Wu LH, Wu F, Zhou X, Li Y, et al. Evaluating immune-inflammatory indices for risk stratification in cardiovascular disease: an umbrella review of systematic reviews and meta-analyses. Diagnostics (Basel). 2025;15(22):2862.
• Luo Y, Yang L, Cheng X, Bai Y, Xiao Z. The association between blood count-based inflammatory markers and the risk of atrial fibrillation, heart failure and cardiovascular mortality. Sci Rep. 2025;15:10056.
• Ye Z, Hu T, Wang J, Xiao R, Liao X, Liu M, et al. Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: a systematic review and meta-analysis. Front Cardiovasc Med. 2022;9:933913.
• Karadeniz FO, Karadeniz Y, Altuntas E. SII and NLR/PLR ratios can predict clinical outcomes in acute coronary syndrome. Cardiovasc J Afr. 2023;Advance online publication.
• Yang P, Li H, Zhang J, Xu X. Research progress on biomarkers of pulmonary embolism. Clin Respir J. 2021;15(10):1046-55.
• Tuzimek A, Dziedzic EA, Beck J, Kochman W. Correlations between acute coronary syndrome and novel inflammatory markers (SII, SIRI, AISI) in patients with and without diabetes or prediabetes. J Inflamm Res. 2024;17:2623-32.
• Samedov BD, Melekoglu A, Kahveci U, Altinbilek E. Prognostic value of systemic inflammation indexes in acute coronary syndrome in emergency department. Signa Vitae. 2025;21(6):74-85.
• Wang H, Huang Z, Wang J, Yue S, Hou Y, Ren R, et al. Predictive value of SII for severity of coronary stenosis in coronary heart disease with diabetes. Sci Rep. 2024;14:31370.
• Jiang P, Chen J, Li J. Association of SII and SIRI with all-cause and cardiovascular mortality in metabolic inflammatory syndrome. Eur J Med Res. 2025;30(1):444.
• Fu T, Deng T. Associations between SIRI and abdominal aortic calcification: a cross-sectional study. Sci Rep. 2025;15:35777.
• Marchi F, Pylypiv N, Parlanti A, Storti S, Gaggini M, Paradossi U, et al. SII and SIRI as predictors of mortality in ST-elevation myocardial infarction. J Clin Med. 2024;13(5):1256.