Is the systemic immune-inflammation index a predictive marker of carotid artery stenosis?

Yıl 2022, Cilt: 5 Sayı: 2, 652 - 658, 15.03.2022

Meltem Karacan Gölen Dilek Yılmaz Okuyan

https://doi.org/10.32322/jhsm.1052129

Cited By: 1

Öz

Introduction: The relationship between inflammation and atherosclerosis and ischemic stroke was shown in studies, and we aimed to evaluate the relationship between the systemic immune-inflammation (SII) index and carotid artery stenosis (CAS) in our study.
Material and Method: Forty patients with CAS with acute cerebrovascular disease and sixty three patients without CAS with acute cerebrovascular disease were included in the study. Demographic characteristics, neutrophil/lymphocyte ratio ( NLR), and the SII indexes of the patients were compared between the groups with and without CAS.
Results: There was a statistically significant difference between the groups in terms of NLR and SII index values (p<0.05). In the ROC analysis, the sensitivity of the SII index was 65% and the specificity was 84.1%, based on a cut-off value of ≥14.032, and the sensitivity and specificity of NLR were 65% and 82.5%, repectively, based on a cut-off value ≥4.701. In terms of prognosis, poor outcome (mRS 3-6) was detected in 22/40 (55%) in the group with CAS, and a statistically significant difference was found between the groups (p<0.05). When evaluated in terms of mortality, the 1-month mortality rate in the group with CAS was 20% (8/40), and 4.8% (3/63) in the group without CAS (p<0.05).
Conclusion: In our study, the SII index and NLR were thought to be markers associated with the presence of CAS in patients with symptomatic CAS, and higher NLR and SII index values were found to be associated with poor prognosis and mortality.

Anahtar Kelimeler

Carotid artery stenosis, inflammation, systemic immune-inflammation index, neutrophil/lymphocyte ratio

Kaynakça

• Feigin VL, Krishnamurthi RV, Parmar P, et al. Update on teh Global Burden of ischemic and Hemorrhagic Stroek in 1990-2013 The GBD 2013 Study. Neuroepidomiology 2015; 45: 161-76.
• Liapis CD, Bell PR, Mikhailidis D, et al, ESVS Guidelines Collaborators. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques. Eur J Vasc Endovasc Surg 2009; 37: 1-19.
• Flaherty ML,Kissela B, Khoury JC et al. Carotid artery stenosis as a cause of stroke. Neuroepidomyology 2013; 40: 36-41.
• Espinola-Klein C, Rupprecht HJ, Blankenberg S, et al. Athero Gene Investigators. Impact of infectious burden on extent and long-term prognosis of atherosclerosis. Circulation 2002; 105: 15-21.
• Utku U, Çelik Y.İnmede etyoloji sınıflandırma ve risk faktörleri Serebrovasküler Hastalıklar Güneş Tıp Yayınevi 2009 S: 51-62.
• Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, and Prevention.Circ Res 2017; 120: 472-95.
• Jander S, Sitzer M, Schumann R, et al. Inflammation in high-grade carotid stenosis: a possible role for macrophages and T cells in plaque destabilization. Stroke 1998; 29: 1625-30.
• Anderson JL, Carlquist JF, Muhlestein JB, Horne BD, Elmer SP. Evaluation of C-reactive protein, an inflammatory marker, and infectious serology as risk factors for coronary artery disease and myocardial infarction. J Am Coll Cardiol 1998; 32: 35-41.
• Darbousset R, Thomas GM, Mezouar S, et al. Tissue factor-positive neutrophils bind to injured endothelial wall and initiate thrombus formation. Blood 2012; 120: 2133-43.
• Arvin B, Neville LF, Barone FC, Feuerstein GZ. The rol of inflamation and cytokines in brain injury. Neurosci Biobehav Rev 1996: 20: 445-52.
• Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women . N Engl J Med 2000; 342: 836-43.
• Emerging Risk Factors Collaboration, Kaptoge S, Di Angelantonio E, Lowe G et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 2010; 375: 132-40.
• Zhou Y, Han W, Gong D, Man C, Fan Y. Hs-crp in stroke: a meta-analysis. Clinica Chimica Acta; Int J Clin Chem 2016; 453: 21–7.
• Wang L, Song Q, Wang C et al. Neutrophil to lymphocyte ratio predicts poor outcomes after acute ischemic stroke: A cohort study and systematic review. J Neurol Sci 2019; 406: 116445.
• Fest J, Ruiter R, Ikram MA, Voortman T, van Eijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study. Sci Rep 2018; 8: 10566.
• Yi HJ, Sung JH, Lee DH. Systemic inflammation response index and systemic immune-inflammation index are associated with clinical outcomes in patients treated with mechanical thrombectomy for large artery occlusion. World Neurosurg 2021; 153: e282-e289.
• Adams HP Jr, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993; 24: 35-41.
• Erdoğan M, Erdöl MA, Öztürk S, Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med 2020; 14: 1553-61.
• Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020; 50: e13230.
• Nasr N, Ruidavets JB, Arnal JF, Sie P, Larrue V. Association of neutrophil count with microembolization in patients with symptomatic carotid artery stenosis. Atherosclerosis 2009; 207: 519-23.
• Yüksel İÖ, Köklü E, Arslan Ş, et al.Association of neutrophil/lymphocyte ratio with plaque morphology in patients with asymptomatic intermediate carotid artery stenosis. Korean Circ J 2016; 46: 699-705.
• Köklü E, Yüksel İÖ, Arslan Ş, et al. Is elevated neutrophil-to-lymphocyte ratio a predictor of stroke in patients with intermediate carotid artery stenosis? J Stroke Cerebrovasc Dis 2016; 25: 578-84.
• Pereira-Neves A, Fragão-Marques M, Rocha-Neves J, et al. The impact of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratıo in carotıd artery dısease. Rev Port Cir Cardiotorac Vasc 2021; 28: 45-51.
• Topcuoglu MA, Pektezel MY, Yilmaz E, Arsava EM. Systemic inflammation indices in patients with acute ischemic stroke treated with intravenous tissue plasminogen activator: clinical yield and utility. Angiology 2021; 72: 279-284.
• Yang Y, Han Y, Sun W, Zhang Y. Increased systemic immune-inflammation index predicts hemorrhagic transformation in anterior circulation acute ischemic stroke due to large-artery atherosclerotic. Int J Neurosci 2021: 1-7.
• Li LH, Chen CT, Chang YC, Chen YJ, Lee IH, How CK. Prognostic role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in acute ischemic stroke: A STROBE-compliant retrospective study. Medicine (Baltimore) 2021; 100: e26354.
• Hou D, Wang C, Luo Y, et al.Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS). Int J Neurosci 2020: 1-6.
• Li S, Liu K, Gao Y et al. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol 2020; 5: 368-73.
• Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget 2017; 8: 75381-8.
• Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20: 6212-22.
• Passardi A, Scarpi E, Cavanna L, et al. Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer. Oncotarget 2016; 7: 33210-9.