The predictive role of systemic immune-inflammation index in non-ischemic cardiomyopathy

Yıl 2024, , 36 - 41, 29.02.2024

Murat Oğuz Özilhan , Gökhan Gökalp

https://doi.org/10.47582/jompac.1421111

Öz

Aims: The systemic immune-inflammation index (SII), a useful marker of systemic inflammation, has been shown to be associated with cardiovascular diseases in previous studies. Inflammation is known to have a significant role in heart failure, but no study has evaluated the relationship between inflammatory parameters and prognosis in patients with non-ischemic cardiomyopathy (NICM). This study aimed to explore the relationship between SII and long-term mortality in patients with non-ischemic cardiomyopathy.
Methods: The study enrolled 326 consecutive patients with NICM. The median 25-month follow-up mortality results of the patients were recorded retrospectively. SII, a combined index based on the count of three parameters, was calculated as follows: neutrophil count x platelet count/lymphocyte count. Patients with a higher SII value than the median SII were accepted as having a high SII, and the remaining patients were defined as having a low SII. The survival curves of the patients with high and low SII values during the study period were analyzed using the Kaplan-Meier method.
Results: The mean age of the participants was 46.6 years. The mean SII value was 598.4 in patients without mortality and 722.7 in those with mortality. In the multivariate logistic regression analysis, SII was found to be an independent predictor of mortality. The median SII value of the patients who participated in the study was 644. Upon dividing the patients into two groups according to the median SII value, the mortality rate was determined to be 48.4% in the high SII group and 27.4% in the low SII group.
Conclusion: High SII values were observed to be associated with long-term mortality in patients with NICM. SII, which is easily accessed and simply calculated, can be used to predict mortality risk in these patients. Prospective and larger cohort studies are needed to clarify the causality of this relationship.

Anahtar Kelimeler

Heart failure, non-ischemic cardiomyopathy, systemic immune-inflammation index

İskemik olmayan kardiyomiyopatili hastalarda sistemik inflamasyon mortaliteyi öngördürür mü?

Öz

Amaç: Sistemik inflamasyonun yararlı bir belirteci olan sistemik immün-inflamatuvar indeks (SII) kardiyovasküler hastalıklarla ilişkilidir. İnflamasyonun kalp yetersizliği ile takipli hastalarda önemli bir rolü olduğu bilinmektedir. Bununla birlikte iskemik olmayan kardiyomiyopati (NİKMP) hastalarında inflamatuvar parametreler ile prognoz arasındaki ilişkiyi değerlendiren bir çalışma bulunmamaktadır. Bizim çalışmamız, iskemik olmayan kardiyomiyopatili hastalarda SII ile uzun dönem mortalite arasındaki ilişkiyi araştırmayı amaçlamaktadır.
Gereç ve Yöntem: NIKMP ile takipli 326 ardışık hasta çalışmaya dahil edilmiştir. Hastaların medyan takip süresi 25 aydır. Bu süreçte ölüm verileri retrospektif olarak kaydedilmiştir. Sistemik immün inflamasyon indeksi, nötrofil, trombosit ve lenfosit olmak üzere üç parametrenin sayımına dayanan kombine bir indekstir. SII, nötrofil sayısı x trombosit sayısı/lenfosit sayısı şeklinde hesaplanmıştır.
Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 46.6 ‘dır. Ortalama SII değeri takip süresince mortalite yaşanmayan hastalarda 598.4, mortalite yaşanan hastalarda ise 722.7 olarak hesaplanmıştır. Çok değişkenli lojistik regresyon analizinde, SII ' nin mortalitenin bağımsız bir öngörücüsü olduğu bulunmuştur. Çalışmaya katılan hastaların medyan SII değeri 644 idi. Hastalar medyan SII değerine göre yüksek SII ve düşük SII olarak iki gruba ayrıldığında, mortalite oranı yüksek SII grubunda %48.4, düşük SII grubunda ise %27.4 olarak saptanmıştır.
Sonuç: NIKMP ile takipli hastalarda yüksek SII değerinin uzun dönem mortalite ile ilişkili olduğu gösterilmiştir. Bu hasta grubunda kolay ulaşılan ve basitçe hesaplanabilen SII, mortalite riskini tahmin etmede kullanılabilir. Prospektif ve daha geniş hasta grupları ile yapılan çalışmalarla bu ilişkinin nedenselliğini açıklamaya ihtiyaç vardır.

Anahtar Kelimeler

kalp yetersizliği, iskemik olmayan kardiyomiyopati, sistemik immün-inflamasyon indeksi

Kaynakça

• Hodler J, Kubik-Huch RA, von Schulthess GK, eds. Diseases of the chest, breast, heart and vessels 2019-2022: Diagnostic and Interventional Imaging. Springer: 2019.
• Li X, Zhang X, Liu Y, et al. Relationship between serum chloride and prognosis in non-ischaemic dilated cardiomyopathy: a large retrospective cohort study. BMJ Open. 2022;12(12):e067061.
• Hershberger RE, Hedges DJ, Morales A. Dilated cardiomyopathy: the complexity of a diverse genetic architecture. Nat Rev Cardiol. 2013;10(9):531-547.
• Del Mestre E, Pio Loco Detto Gava C, Paldino A, et al. Arrhythmic risk stratification in non-ischaemic dilated cardiomyopathy. Eur Heart J Suppl. 2023;25(Supplement_B):B144-B148.
• Weintraub RG, Semsarian C, Macdonald P. Dilated cardiomyopathy. Lancet. 2017;390(10092):400-414.
• Merlo M, Cannatà A, Gobbo M, Stolfo D, Elliott PM, Sinagra G. Evolving concepts in dilated cardiomyopathy. Eur J Heart Fail. 2018;20(2):228-239.
• Sinagra G, Merlo M, Pinamonti B, eds. Dilated Cardiomyopathy: From Genetics to Clinical Management. Springer: 2019.
• Zecchin M, Merlo M, Pivetta A, et al. How can optimization of medical treatment avoid unnecessary implantable cardioverter-defibrillator implantations in patients with idiopathic dilated cardiomyopathy presenting with “SCD-HeFT criteria?”. Am J Cardiol. 2012;109(5):729-735.
• Halliday BP, Gulati A, Ali A, et al. Sex- and age-based differences in the natural history and outcome of dilated cardiomyopathy. Eur J Heart Fail. 2018;20(10):1392-1400.
• Ferreira A, Ferreira V, Antunes MM, et al. Dilated cardiomyopathy: a comprehensive approach to diagnosis and risk stratification. Biomedicines. 2023;11(3):834.
• Simon T, Becker R, Voss F, et al. Elevated B-type natriuretic peptide levels in patients with nonischemic cardiomyopathy predict occurrence of arrhythmic events. Clin Res Cardiol. 2008;97(5):306-309.
• Cesari M, Penninx BW, Newman AB, et al. Inflammatory markers and onset of cardiovascular events: results from the health ABC study. Circulation. 2003;108(19):2317-2322.
• Sampietro T, Neglia D, Bionda A, et al. Inflammatory markers and serum lipids in idiopathic dilated cardiomyopathy. Am J Cardiol. 2005;96(12):1718-1720.
• Kaneko K, Kanda T, Yamauchi Y, et al. C-Reactive protein in dilated cardiomyopathy. Cardiol. 1999;91(4):215-219.
• Wang BL, Tian L, Gao XH, et al. Dynamic change of the systemic immune inflammation index predicts the prognosis of patients with hepatocellular carcinoma after curative resection. Clin Chem Lab Med. 2016;54(12):1963-1969.
• Tang Y, Zeng X, Feng Y, et al. Association of systemic immune-inflammation index with short-term mortality of congestive heart failure: a retrospective cohort study. Front Cardiovasc Med. 2021;8:753133.
• Öcal L, Keskin M, Cerşit S, et al. Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction. Coron Artery Dis. 2022;33(4):251-260.
• Wang Y, Ni Q. Prognostic and clinicopathological significance of systemic immune-inflammation index in cancer patients receiving immune checkpoint inhibitors: a meta-analysis. Ann Med. 2023;55(1):808-819.
• Xie Y, Cen H, Wang L, et al. Relationships between inflammatory parameters derived from complete blood count and quantitative flow ratio in patients with stable coronary artery disease. Angiol. 2023:00033197231197804. doi: 10.1177/00033197231197804
• Wang X, Ni Q, Wang J, Wu S, Chen P, Xing D. Systemic inflammation response index is a promising prognostic marker in elderly patients with heart failure: a retrospective cohort study. Front Cardiovasc Med. 2022;9:871031.
• Yuan M, Ren F, Gao D. The value of SII in predicting the mortality of patients with heart failure. Dis Markers. 2022;2022:3455372.
• Lin KB, Fan FH, Cai MQ, et al. Systemic immune inflammation index and system inflammation response index are potential biomarkers of atrial fibrillation among the patients presenting with ischemic stroke. Eur J Med Res. 2022;27(1):106.
• Wu AH. Management of patients with non-ischaemic cardiomyopathy. Heart. 2007;93(3):403-408.
• Zhang ZH, Meng FQ, Hou XF, et al. Clinical characteristics and long-term prognosis of ischemic and non-ischemic cardiomyopathy. Indian Heart J. 2020;72(2):93-100.
• Cho JH, Cho HJ, Lee HY, et al. Neutrophil-lymphocyte ratio in patients with acute heart failure predicts in-hospital and long-term mortality. J Clin Med. 2020;9(2):557.
• Reina-Couto M, Pereira-Terra P, Quelhas-Santos J, Silva-Pereira C, Albino-Teixeira A, Sousa T. Inflammation in human heart failure: major mediators and therapeutic targets. Front Physiol. 2021;12:746494.
• Strand ME, Vanhaverbeke M, Henkens MTHM, et al. Inflammation and syndecan-4 shedding from cardiac cells in ischemic and non-ischemic heart disease. Biomedicines. 2023;11(4):1066.
• Rauchhaus M, Doehner W, Francis DP, et al. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation. 2000;102(25):3060-3067.
• Kearney MT, Fox KA, Lee AJ, et al. Predicting death due to progressive heart failure in patients with mild-to-moderate chronic heart failure. J Am Coll Cardiol. 2002;40(10):1801-1808.