Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
Department of Cardiology, Traditional Chinese Medicine Hospital of Shuangliu District, Chengdu, China.
Ups J Med Sci. 2021 Dec 3;126. doi: 10.48101/ujms.v126.8124. eCollection 2021.
This study investigates the predictive value of the systemic immune-inflammation index (SII), which was calculated as platelet × neutrophil/lymphocyte ratio, for all-cause mortality in patients with hypertrophic cardiomyopathy (HCM).
A total of 360 HCM patients were enrolled. They were divided into three groups based on the tertiles of baseline SII. The association between SII and all-cause mortality was analyzed.
There were 53 HCM patients who died during a mean follow-up time of 4.8 years (min: 6 days and max: 10.8 years), and the mortality rate was 3.0 per 100 person years. The cumulative mortality rate was significantly different among the three tertiles of SII ( = 0.004), and the mortality rate in tertile 3 was much higher than that in the first two tertiles. In reference to tertile 1, the fully adjusted hazard ratios of all-cause mortality were 1.02 for the tertile 2 (95% confidence interval [CI]: 0.45-2.31, = 0.966) and 2.31 for tertile 3 (95% CI: 1.10-4.87, = 0.027). No significant interactions between SII and other variables were observed during subgroup analysis. The discriminative power was better for mid-term outcome than that for short-term or long-term outcomes. Sensitivity analyses including patients with normal platelet and white blood cell count have revealed similar results.
SII was a significant risk factor for all-cause mortality in HCM patients. However, the discriminative power was poor to moderate. It could be used in combination with other risk factors in mortality risk stratification in HCM.
本研究旨在探讨血小板×中性粒细胞/淋巴细胞比值(SII)作为系统性免疫炎症指数对肥厚型心肌病(HCM)患者全因死亡率的预测价值。
共纳入 360 例 HCM 患者。根据 SII 的三分位数将患者分为三组。分析 SII 与全因死亡率之间的关系。
在平均 4.8 年(最短:6 天,最长:10.8 年)的随访期间,共有 53 例 HCM 患者死亡,死亡率为 3.0/100 人年。三组 SII 的累积死亡率差异有统计学意义(=0.004),第三组的死亡率明显高于前两组。与第一组相比,第二组的全因死亡率的校正风险比为 1.02(95%置信区间:0.45-2.31,=0.966),第三组为 2.31(95%置信区间:1.10-4.87,=0.027)。亚组分析未观察到 SII 与其他变量之间存在显著交互作用。SII 对中期预后的判别能力优于短期或长期预后。包括血小板和白细胞计数正常的患者在内的敏感性分析得出了类似的结果。
SII 是 HCM 患者全因死亡率的重要危险因素,但判别能力为中等或较低。它可以与其他危险因素结合用于 HCM 患者的死亡风险分层。