The role of the systemic inflammatory response index in the prediction of chronic total occlusion: useful or not?

Abstract

Aim: Inflammation is very important in the pathogenesis of atherosclerosis and CAD. Chronic total occlusion (CTO) is a chronic form of CAD and is common in patients with severe CAD. The aim of this study was to determine the association of the systemic inflammatory response index (SIRI), a marker of inflammation, with CTO. Materials and Methods: Our study was retrospective and included 100 CAD patients with CTO and 100 CAD patients without CTO. SIRI was compared between the two groups. Results: Among the basic clinical and laboratory characteristics of the patients, age, white blood cell, and neutrophil counts were statistically higher in the CTO group (p=0.044, p=0.044, p=0.036, respectively). SIRI parameters were similar between the groups, and no statistical difference was observed (p=0.111). According to the ROC analysis, the optimum cut-off value for SIRI was >1040 (sensitivity 70.0% and specificity 44.0%). Conclusion: SIRI is not a useful predictor for the detection of CTO.

Keywords

• Systemic inflammatory response index
• chronic total occlusion
• coronary artery disease

Sistemik inflamatuar yanıt indeksin(SIRI) kronik total oklüzyon öngörülmesinde rolü: yararlı mı değil mi?

Abstract

ÖZET Amaç: Ateroskleroz ve KAH patojeninizde inflamasyon oldukça önemlidir. Kronik total oklüzyon (KTO) KAH’ın kronik bir formudur ve ciddi KAH olanlarda sık görülür. Bu çalışmanın amacı inflamasyon göstergelerinden biri olan sistemik inflamatuar yanıt indeksin (SIRI) KTO ile olan ilişkisini ortaya koymaktır. Gereç ve Yöntem: Çalışmamız retrospektif olup 100 adet KTO’u olan ve 100 adet KTO’u olmayan KAH hastası çalışmaya dahil edildi. 2 grup arasında SIRI karşılaştırıldı. Bulgular: Hastaların temel klinik ve laboratuvar özellikleri arasında yaş, beyaz kan hücresi ve nötrofil sayısı KTO su olan grupta istatiksel olarak daha yüksek saptandı. (Sırası ile p=0,044, p=0,044, p=0,036). Gruplar arasında SIRI parametreleri benzer olarak saptanmış olup istatiksel farklılık izlenmedi. (p=0,111). Yapılan ROC analizine göre SIRI için optimum cut-off değeri >1040 (sensitivite %70.0 ve spesifite %44.0) olarak elde edilmiştir. Sonuç: SIRI KTO saptanmasında kullanışlı bir prediktör değildir.

Keywords

• Sistemik inflamatuar yanıt indeks
• kronik total oklüzyon
• koroner arter hastalığı

References

1. Dagenais GR, Leong DP, Rangarajan S, et al. Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study. Lancet. 2020;395(10226):785-794.
2. Sianos G, Werner GS, Galassi AR, et al. Recanalisation of chronic total coronary occlusions: 2012 consensus document from the EuroCTO club. EuroIntervention. 2012;8(1):139-145.
3. Kahn JK. Angiographic suitability for catheter revascularization of total coronary occlusions in patients from a community hospital setting. Am Heart J. 1993;126(3 Pt 1):561-564.
4. Christofferson RD, Lehmann KG, Martin GV, Every N, Caldwell JH, Kapadia SR. Effect of chronic total coronary occlusion on treatment strategy. Am J Cardiol. 2005;95(9):1088-1091.
5. Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(3):e18-e114.
6. Gebhard C, Toma A, Min Z, et al. Preprocedural leucocyte count predicts risk in patients with coronary chronic total occlusion. Thromb Haemost. 2017;117(11):2105-2115.
7. Li S, Chen H, Zhou L, Cui H, Liang S, Li H. Neutrophil-to-lymphocyte ratio predicts coronary artery lesion severity and long-term cardiovascular mortality in patients with unstable angina pectoris. Acta Cardiol. 2022;77(8):708-715.
8. Isik T, Uyarel H, Tanboga IH, et al. Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease. Coron Artery Dis. 2012;23(1):51-56.

9. Eyyupkoca F, Kocak A, Yildirim O, et al. Systemic immune-inflammation index predicted presence and severity of coronary artery disease. Ann Med Res. 2022;29(8):794-801.
10. Dziedzic EA, Gąsior JS, Tuzimek A, 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.
11. Boyaci F, Akçay M, Gökdeniz T. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in predicting chronic total occlusion in ST-segment elevation myocardial infarction. Harran Üniversitesi Tıp Fakültesi Derg. 2022;19(2):277-283.
12. Açıkgöz SK, Akboğa MK, Açıkgöz E, Yayla Ç, Şensoy B, Aydoğdu S. Red cell distribution width predicts totally occluded infarct-related artery in NSTEMI. Scand Cardiovasc J. 2016;50(4):224-229.
13. Yarlioglues M, Kurtul A. Association of red cell distribution width with noninfarct-related artery-chronic total occlusion in acute myocardial infarction patients. Biomark Med. 2017;11(3):255-263.
14. Demir M, Özbek M. A novel predictor in patients with coronary chronic total occlusion: systemic immune-inflammation index: a single-center cross-sectional study. Rev Assoc Med Bras (1992). 2022;68(5):579-585.
15. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352(16):1685-1695.
16. Tani S, Matsumoto M, Anazawa T, et al. Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count. Heart Vessels. 2012;27(2):143-150.
17. Yuan Y, Li P, Ye J. Lipid homeostasis and the formation of macrophage-derived foam cells in atherosclerosis. Protein Cell. 2012;3(3):173-181.
18. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102(6):653-657.
19. Huang G, Zhong XN, Zhong B, et al. Significance of white blood cell count and its subtypes in patients with acute coronary syndrome. Eur J Clin Invest. 2009;39(5):348-358.
20. Major AS, Fazio S, Linton MF. B-lymphocyte deficiency increases atherosclerosis in LDL receptor-null mice. Arterioscler Thromb Vasc Biol. 2002;22(11):1892-1898.
21. Ducloux D, Challier B, Saas P, Tiberghien P, Chalopin JM. CD4 cell lymphopenia and atherosclerosis in renal transplant recipients. J Am Soc Nephrol. 2003;14(3):767-772.
22. Qi Q, Zhuang L, Shen Y, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016;122(14):2158-2167.
23. Urbanowicz T, Michalak M, Komosa A, et al. Predictive value of systemic inflammatory response index (SIRI) for complex coronary artery disease occurrence in patients presenting with angina equivalent symptoms. Cardiol J. 2023;10.5603/CJ.a2023.0033.
24. Candemir M, Kiziltunç E, Nurkoç S, Şahinarslan A. Relationship between systemic immune-inflammation index (SII) and the severity of stable coronary artery disease. Angiology. 2021;72(6):575-581.
25. Liu Y, Ye T, Chen L, et al. Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease. Coron Artery Dis. 2021;32(8):715-720.
26. Şahin İ, Karabulut A, Kaya A, et al. Increased level of red cell distribution width is associated with poor coronary collateral circulation in patients with stable coronary artery disease. Turk Kardiyol Dern Ars. 2015;43(2):123-130.
27. Dash D. Coronary chronic total occlusion intervention: A pathophysiological perspective. Indian Heart J. 2018;70(4):548-555.
28. Bassuk SS, Rifai N, Ridker PM. High-sensitivity C-reactive protein: clinical importance. Curr Probl Cardiol. 2004;29(8):439-493.