The Role of Systemic Immune-Inflammation Index in Severe Bicuspid Aortic Stenosis

Year 2026, Volume: 12 Issue: 1, 22 - 31, 04.01.2026

Hakan Süygün

https://doi.org/10.18621/eurj.1759091

https://izlik.org/JA73XL55RB

Abstract

Objectives: Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality and often leads to severe aortic stenosis (AS) at a younger age compared to tricuspid valves. Inflammation plays a key role in the pathogenesis of AS. This study aimed to investigate the association between the Systemic Immune-Inflammation Index (SII) and disease severity in patients with severe BAV-AS.

Methods: In this retrospective observational study, 76 patients with severe BAV-AS and 76 age- and sex-matched controls without AS were included. Routine laboratory data and transthoracic echocardiographic parameters were recorded. SII was calculated as platelet count × neutrophil count / lymphocyte count. The severity of AS was determined by aortic valve area (AVA) and mean transvalvular gradient. Correlation analyses, Receiver Operating Characteristic (ROC) curve, and logistic regression were used to assess the relationship between SII and AS severity.

Results: The BAV-AS group had significantly higher SII values compared to controls (median: 931.7 vs. 534; P<0.001). SII showed a moderate inverse correlation with AVA (r = –0.547) and a positive correlation with mean gradient (r=0.535). The optimal SII cut-off for predicting severe BAV-AS was 691 (AUC=0.790), with sensitivity of 71.1% and specificity of 77.6%. Multivariate analysis identified SII as an independent predictor of severe BAV-AS (OR: 3.841, 95% CI: 1.395-10.576; P=0.009).

Conclusions: SII is significantly elevated in patients with severe BAV-AS and may serve as a useful inflammatory biomarker for disease burden. Further studies are needed to confirm its utility in clinical decision-making.

Keywords

Bicuspid Aortic Valve , Systemic Immune-Inflammation Index , Aortic Stenosis , Inflammation , Echocardiography , Biomarkers

Ethical Statement

This study was approved by the the local Ethical Committee of the Karamanoglu Mehmetbey University, Karaman, Turkiye (Decision No: 2025/04-21; date: 04.06.2025). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Informed consent was waived because of the retrospective nature of the study and the analysis used anonymous clinical data.

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