ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗后全身免疫炎症指数（SII）与院内新发心力衰竭的相关性
Association between Systemic Immune-Inflammation Index (SII) and New-Onset In-Hospital Heart Failure in Patients with STEMI after Primary PCI.
作者信息
Wang Huibo, Yang Ying, Zeng Ping, Huang Rihong, Cai Xinyong, Shao Liang, Liu Fuyuan, Lei Yuhua, Li Dongsheng, Fan Zhixing, Yang Jun, Zhang Jing, Yang Jian
机构信息
Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital, 443000 Yichang, Hubei, China.
Department of Cardiology, Institute of Cardiovascular Diseases, China Three Gorges University, 443000 Yichang, Hubei, China.
出版信息
Rev Cardiovasc Med. 2024 Oct 24;25(10):382. doi: 10.31083/j.rcm2510382. eCollection 2024 Oct.
BACKGROUND
The systemic immune-inflammation index (SII) is a proven, reliable inflammatory marker of the atherosclerotic process. Additionally, inflammation is one of the most important mechanisms of heart failure (HF) after myocardial infarction (MI). However, it is not clear whether SII is related to the risk of in-hospital HF in patients with MI. Thus, we aimed to explore the relationship between SII and the risk of new-onset in-hospital HF in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI).
METHODS
A total of 5586 patients with STEMI underwent pPCI at seven clinical sites in China from January 2015 to August 2021. The patients were divided into two groups based on the SII values. The association between SII and new-onset in-hospital HF in STEMI patients was assessed using logistic regression analysis.
RESULTS
Ultimately, 3808 STEMI patients with Killip class I who were treated with pPCI were included. All included patients were divided into two groups based on the calculated SII (Q1 SII: <1707.31 (×10/L), Q2 SII: ≥1707.31 (×10/L)). After unadjusted and multivariate adjustment for age, gender, vital signs, smoking, hypertension, diabetes mellitus, ., the odds ratio (OR) of the in-hospital HF risk in Q2 was 1.378-1.427 times the Q1 in the calibration Models 1 to 5. Subgroup analysis showed that the OR of Q2 was 1.505-fold higher of Q1 in males and 1.525-fold in older people (≥60 years). Sensitivity analysis showed that after excluding patients who had previously experienced HF, MI, or underwent PCI, elevated SII was still associated with a significant increase in the risk of in-hospital HF.
CONCLUSIONS
Elevated SII is associated with an increased risk of in-hospital HF in STEMI patients treated with pPCI, particularly in male and older patients.
CLINICAL TRIAL REGISTRATION
The Chinese STEMI pPCI Registry was registered with ClinicalTrials.gov (NCT04996901, https://www.clinicaltrials.gov/study/NCT04996901?cond=NCT04996901&rank=1).
背景
全身免疫炎症指数（SII）是动脉粥样硬化进程中一种经过验证的、可靠的炎症标志物。此外，炎症是心肌梗死（MI）后心力衰竭（HF）最重要的机制之一。然而，尚不清楚SII是否与MI患者住院期间发生HF的风险相关。因此，我们旨在探讨SII与接受直接经皮冠状动脉介入治疗（pPCI）的ST段抬高型心肌梗死（STEMI）患者住院期间新发HF风险之间的关系。
方法
2015年1月至2021年8月，共有5586例STEMI患者在中国的7个临床中心接受了pPCI治疗。根据SII值将患者分为两组。采用逻辑回归分析评估STEMI患者中SII与住院期间新发HF之间的关联。
结果
最终，纳入了3808例接受pPCI治疗的Killip I级STEMI患者。根据计算出的SII将所有纳入患者分为两组（Q1 SII：<﹒1707.31（×10/L），Q2 SII：≥1707.31（×10/L））。在校正模型1至5中，对年龄、性别、生命体征、吸烟、高血压、糖尿病等进行未调整和多变量调整后，Q2组住院期间发生HF风险的比值比（OR）是Q1组的1.378 - 1.427倍。亚组分析显示，男性中Q2组的OR比Q1组高1.505倍，老年人（≥60岁）中高1.525倍。敏感性分析显示，排除既往有HF、MI或接受过PCI的患者后，SII升高仍与住院期间HF风险显著增加相关。
结论
SII升高与接受pPCI治疗的STEMI患者住院期间发生HF的风险增加相关，尤其是男性和老年患者。
临床试验注册
中国STEMI pPCI注册研究已在ClinicalTrials.gov注册（NCT04996901，https://www.clinicaltrials.gov/study/NCT04996901?cond=NCT04996901&rank=1） 。
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