Qu Chao, Li Xiang, Gao Hai
Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
Rev Cardiovasc Med. 2023 May 19;24(5):153. doi: 10.31083/j.rcm2405153. eCollection 2023 May.
Inflammation is essential in cardiovascular disease (CVD) development and progression. A novel inflammatory parameter, the systemic inflammation response index (SIRI), has been proven to predict cancer prognosis strongly. Little is known about the relationship between SIRI and outcomes in patients with ST-segment elevation myocardial infarction (STEMI).
1312 STEMI patients who underwent percutaneous coronary intervention (PCI) in Beijing Anzhen hospital from January 2019 to December 2021 were analyzed. SIRI was calculated as neutrophils monocytes/lymphocytes. Our primary outcome was a 30-day major adverse event (MACE), including all-cause mortality, non-fatal myocardial infarction (MI), stroke, incident heart failure (HF), cardiogenic shock, and cardiac arrest.
Patients were stratified into four groups according to quartiles of SIRI: SIRI 1.58 (n = 328), 1.58 SIRI 3.28 (n = 328), 3.28 SIRI 7.80 (n = 328), SIRI 7.80 (n = 328). Higher SIRI was associated with a higher incidence of the 30-day MACE. The rates of 30-day MACE were 6.1%, 8.8%, 12.8%, and 17.1% ( 0.001) for the lowest SIRI quartile to the highest quartile, respectively. This association was consistent in the outcome of HF but no other components. Higher SIRI indicated higher 30-day MACE incidence in most participants except in those with very high inflammatory indicators. Subgroup analysis showed this correlation was consistent in various subgroups ( for interaction 0.05).
In patients with STEMI, higher SIRI indicated a higher incidence of 30-day MACE, except for those with very high inflammatory indicators. In most STEMI patients, SIRI might be a trustworthy indicator of short-term prognosis.
炎症在心血管疾病（CVD）的发生和发展中至关重要。一种新的炎症参数，即全身炎症反应指数（SIRI），已被证明能有力地预测癌症预后。关于SIRI与ST段抬高型心肌梗死（STEMI）患者预后之间的关系，人们了解甚少。
分析了2019年1月至2021年12月在北京安贞医院接受经皮冠状动脉介入治疗（PCI）的1312例STEMI患者。SIRI计算为中性粒细胞/单核细胞/淋巴细胞。我们的主要结局是30天主要不良事件（MACE），包括全因死亡率、非致命性心肌梗死（MI）、中风、新发心力衰竭（HF）、心源性休克和心脏骤停。
根据SIRI四分位数将患者分为四组：SIRI≤1.58（n = 328），1.58＜SIRI≤3.28（n = 328），3.28＜SIRI≤7.80（n = 328），SIRI＞7.80（n = 328）。较高的SIRI与30天MACE的较高发生率相关。最低SIRI四分位数到最高四分位数的30天MACE发生率分别为6.1%、8.8%、12.8%和17.1%（P＜0.001）。这种关联在HF结局中是一致的，但在其他组成部分中并非如此。除炎症指标非常高的患者外，较高的SIRI表明大多数参与者30天MACE发生率较高。亚组分析表明，这种相关性在各个亚组中是一致的（交互作用P＞0.05）。
在STEMI患者中，除炎症指标非常高的患者外，较高的SIRI表明30天MACE发生率较高。在大多数STEMI患者中，SIRI可能是短期预后的可靠指标。
