Li Tianyu, Wang Peizhi, Wang Xiaozeng, Liu Zhenyu, Zhang Zheng, Zhang Yongzhen, Wang Zhifang, Feng Yingqing, Wang Qingsheng, Guo Xiaogang, Tang Xiaofang, Xu Jingjing, Song Ying, Chen Yan, Xu Na, Yao Yi, Liu Ru, Zhu Pei, Han Yaling, Yuan Jinqing
National Clinical Research center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Cardiovascular Research Institute & Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China.
iScience. 2023 Sep 28;26(11):108060. doi: 10.1016/j.isci.2023.108060. eCollection 2023 Nov 17.
Patients with coronary artery disease (CAD) at low residual inflammatory risk are often overlooked in research and practice. This study examined the associations between fourteen inflammatory indicators and all-cause mortality in 5,339 CAD patients with baseline high-sensitivity C-reactive protein (hsCRP) <2 mg/L who received percutaneous coronary intervention and statin and aspirin therapy. The median follow-up time was 2.1 years. Neutrophil-derived systemic inflammatory response index (SIRI) yielded the strongest and most robust association with all-cause mortality among all indicators. Lower hsCRP remained to be associated with a lower risk of all-cause mortality. A newly developed comprehensive inflammation score (CIS) showed better predictive performance than other indicators, which was validated by an independent external cohort. In conclusion, neutrophil-derived indicators, particularly SIRI, strongly predicted all-cause mortality independent of hsCRP in CAD patients at low residual inflammatory risk. CIS may help identify individuals with inflammation burdens that cannot be explained by hsCRP alone.
低残留炎症风险的冠心病（CAD）患者在研究和临床实践中常被忽视。本研究调查了14种炎症指标与5339例接受经皮冠状动脉介入治疗、他汀类药物和阿司匹林治疗且基线高敏C反应蛋白（hsCRP）<2 mg/L的CAD患者全因死亡率之间的关联。中位随访时间为2.1年。在所有指标中，中性粒细胞衍生的全身炎症反应指数（SIRI）与全因死亡率的关联最强且最为显著。较低的hsCRP水平仍与较低的全因死亡风险相关。一种新开发的综合炎症评分（CIS）显示出比其他指标更好的预测性能，并在一个独立的外部队列中得到验证。总之，在低残留炎症风险的CAD患者中，中性粒细胞衍生指标，尤其是SIRI，能独立于hsCRP强烈预测全因死亡率。CIS可能有助于识别那些炎症负担不能仅由hsCRP解释的个体。
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