The Relationship Between Immune Inflammation Index and Major Cardiovascular Adverse Events in Patients with Heart Failure with Reduced Ejection Fraction.

Öz

Aim: We aimed to investigate whether systemic immune inflammation index (SII) has a predictive value in predicting prognosis and major adverse cardiovascular events such as exitus, stroke and hospitalization in heart failure patients with reduced ejection fraction (HFrEF). Methods: Patients over the age of 18 who applied to the cardiology and emergency outpatient clinics between January 2019 and January 2022 and diagnosed with HFrEF (Ejection Fraction <40%) were retrospectively screened. A total of 597 patients with reliable clinical data were included in the study.The relationship between major adverse cardiovascular events and SII was evaluated. Exitus, stroke and hospitalization were accepted as major adverse cardiovascular events. Result: In patients with HFrEF, SII index was found to be significantly higher in the Exitus (+) group (1504.34±1722.74) when compared with the Exitus (-) group (893.94±972.13) (p=0.014). On the other hand, SII index was not found to be different between the patients with or without stroke and between those with or without hospitalization. When the correlation between the SII index and presence of exitus, stroke, and hospitalization was evaluated, a significant positive correlation was found between the presence of exitus and SII index (r=0.165 p<0.001). A SII index value of 697.29 was found to predict exitus with 604% sensitivity and 607% specificity in heart failure patients (AUC: 0.621,95%CI 0.539-0.704, p=0.04) Conclusion: SII index, which can be calculated easily from lymphocyte, platelet and neutrophil counts, predicts mortality in patients with HFrEF. This index has prognostic significance in patients with HFrEF, suggesting that closer monitoring of elderly patients with a high SII index may be beneficial.

Anahtar Kelimeler

• immun inflammation index
• heart failure
• ejection fraction

Ejeksiyon Fraksiyonu Azalmış Kalp Yetmezliği Olan Hastalarda İmmün Enflamasyon İndeksi ile Majör Kardiyovasküler Olaylar Arasındaki İlişki

Öz

Amaç: Sistemik immün inflamasyon indeksi (SII)’nin, düşük ejeksiyon fraksiyonuna sahip Kalp yetmezliği (HFrEF) hastalarında, exitus, stroke ve hospitalizasyon gibi majör kardiyovaskuler olayları öngörmede, prognozu belirlemede prediktif değeri olup olmadığını araştırmayı amaçladık. Materyel Metod: Çalışmaya Ocak 2019- Ocak 2022 arası kardiyoloji ve acil polikliniğine başvuran 18 yaş üstü, HFrEF’li (Ejeksiyon Fraksiyonu <% 40) tanısı olan hastalar retrospektif olarak tarandı. Güvenilir klinik verileri olan 597 hasta analiz edilmek üzere çalışmaya grubu olarak kabul edildi. Hastaların ilk başvuru sırasındaki sosyodemografik özellikleri, kronik hastalıkları, sigara kullanımı ve hemogram, biyokimya parametreleri, sol ventrikül ejeksiyon fraksiyonları kullandığı ilaçlar kaydedildi. Tam kan sayımları ve biyokimyasal parametreleri incelendi. Sistemik immun inflamasyon indeksi hesaplandı. ). Major kardiyak olaylar ile SII arasındaki ilişki değerlendirildi. Major kardiak olaylar olarak exitus, stroke ve hospitalize olma durumu olarak kabul edildi. Bulgular: , HFrEF’li hastalarda ,SII indeksi açısından gruplar karşılaştırıldığında exitus olan grupta (1504,34±1722,74) exitus olmayan gruba göre ( 893,94±972,13) anlamlı olarak daha yüksek bulundu (p=0,014). Stroke olan ve olmayan, hastaneye yatış olan ve olmayan gruplar SII indeksi açısından karşılaştırıldığında anlamlı bir fark bulunamadı (tablo 2). Exitus varlığı, stroke varlığı ve hastaneye yatış varlığı ile SII indeksi arasında korelasyon bakıldığında exitus varlığı ile SII indeksi arasında anlamlı pozitif korelasyon bulundu (r=0.165 p<0,001) . SII indeksi 697,29 değeri kalp yetmezliği hastalarında Exitusu %604 sensivit, %607 spesivite ile pretikte ettirdiği saptandı (AUC: 0.621, 95%CI 0.539-0.704, p=0.04) Sonuç: HFrEF’lı hastalarda, kolayca bakılan bir tam kan sayımındaki lenfosit, trombosit ve nötrofil sayısından kolayca hesaplanabilen, SII indexinin mortaliteyi, predikte ettirdiğinin saptanmasıdır. Bu indexin HFrEF hastalarında prognostik önemi olduğu, özellikle yaşlı ve SII indexi yüksek hastaların daha yakın izlenmesinin faydalı olabileceğini düşündürmektedir.

Anahtar Kelimeler

• immun enflamasyon indeksi
• kalp yetersizliği
• ejeksiyon fraksiyonu

Kaynakça

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