Yang Xinyu, Tao Ningchao, Wang Teng, Zhang Zisang, Wu Qianyun
Department of Cardiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, China.
Department of Cardiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, China.
Int J Cardiol. 2025 Feb 1;420:132755. doi: 10.1016/j.ijcard.2024.132755. Epub 2024 Nov 23.
Inflammatory markers are considered reliable indicators for predicting adverse outcomes of cardiovascular disease. However, the prognostic significance of composite inflammatory indicators such as the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and inflammatory prognosis index (IPI), in predicting mortality among heart failure (HF) patients remains unknown.
We analyzed data from 1981 patients with HF. The composite inflammatory indicators were calculated based on laboratory test. The endpoint of the study was mortality within six months of follow-up. Cox proportional hazards model and restricted cubic spline analysis were used to assess the association between inflammatory markers and outcomes. The incremental predictive value of composite inflammatory indicators was evaluated using C-index, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
SII, SIRI, and IPI were linearly associated with the risk of death. Compared to the first tertile, the hazard ratios and 95 % confidence intervals (CIs) for mortality in patients in the third tertile for SII, SIRI, and IPI were 2.32 (1.15-4.67), 3.59 (1.56-8.26), and 4.16 (1.20-14.41), respectively. Incorporating composite inflammatory indicators into the basic model significantly enhanced outcome prediction, with IPI showing the greatest incremental predictive value, as indicated by an increase in C-index (0.042, 95 % CI: 0.004-0.095), a continuous NRI of 0.712 (95 % CI: 0.360-1.063, P < 0.001), and an IDI of 0.010 (95 % CI: 0.001-0.019, P = 0.030).
Among patients with HF, elevated levels of SII, SIRI, and IPI were significantly associated with an increased risk of six-month mortality, with IPI providing the greatest incremental predictive value.
炎症标志物被认为是预测心血管疾病不良结局的可靠指标。然而，全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）和炎症预后指数（IPI）等复合炎症指标在预测心力衰竭（HF）患者死亡率方面的预后意义仍不明确。
我们分析了1981例HF患者的数据。复合炎症指标基于实验室检测计算得出。研究终点为随访6个月内的死亡率。采用Cox比例风险模型和受限立方样条分析评估炎症标志物与结局之间的关联。使用C指数、连续净重新分类改善（NRI）和综合判别改善（IDI）评估复合炎症指标的增量预测价值。
SII、SIRI和IPI与死亡风险呈线性相关。与第一三分位数相比，SII、SIRI和IPI第三三分位数患者的死亡风险比及95%置信区间（CI）分别为2.32（1.15 - 4.67）、3.59（1.56 - 8.26）和4.16（1.20 - 14.41）。将复合炎症指标纳入基本模型显著增强了结局预测能力，IPI显示出最大的增量预测价值，表现为C指数增加（0.042，95%CI：0.004 - 0.095）、连续NRI为0.712（95%CI：0.360 - 1.063，P < 0.001）以及IDI为0.010（95%CI：0.001 - 0.019，P = 0.030）。
在HF患者中，SII、SIRI和IPI水平升高与6个月死亡率增加显著相关，其中IPI提供的增量预测价值最大。
