升高的全身免疫炎症指数预示着2型糖尿病慢性完全闭塞患者的冠状动脉侧支循环不良。

Elevated systemic immune-inflammatory index predicts poor coronary collateralization in type 2 diabetic patients with chronic total occlusion.

作者信息

Mao Lin Shuang, Wang Yi Xuan, Wu Zhi Ming, Ding Feng Hua, Lu Lin, Shen Wei Feng, Dai Yang, Shen Ying

机构信息

Department of Cardiovascular Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Front Cardiovasc Med. 2024 Dec 12;11:1490498. doi: 10.3389/fcvm.2024.1490498. eCollection 2024.

DOI:10.3389/fcvm.2024.1490498

PMID:39735863

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11672344/

Abstract

OBJECTIVE

This study compared the value of different systemic immune-inflammatory markers for evaluating coronary collateralization (CC) in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO).

METHODS

Systemic immune-inflammation index (SII), systemic inﬂammation response index (SIRI) and pan-immune-inﬂammation value (PIV) were calculated at admission in 1409 T2DM patients with CTO. The degree of coronary collaterals was estimated using the Rentrop scoring system and categorized into poor (Rentrop score 0 or 1) or good (Rentrop score 2 or 3) CC. The predictors of poor CC were determined by multivariate regression analysis, and the diagnostic potential of these indexes was analyzed by Receiver Operating Characteristic (ROC) curves.

RESULTS

SII, SIRI and PIV levels increased stepwise across Rentrop score 0-3, with significantly higher levels in patients with poor CC than in those with good CC ( < 0.001). After adjusting for confounders, SII, SIRI and PIV (per tertile) remained independent factors for poor CC. SII predicted poor CC better than SIRI and PIV (AUC: 0.758 vs. 0.680 and 0.698, all < 0.001). There existed an interaction between blood concentration of HbA1c and SII ( < 0.001), with high SII levels being associated with a greater risk (OR: 5.058 vs. 2.444) and providing a better predictive ability for poor CC (AUC: 0.817 vs. 0.731) in patients with HbA1c < 6.5% compared to those with HbA1c ≥ 6.5%.

CONCLUSION

Our study shows that elevated SII provides a better prediction for poor CC in T2DM patients with CTO especially at good glycemic control.

摘要

目的

本研究比较了不同全身免疫炎症标志物在评估2型糖尿病（T2DM）合并慢性完全闭塞（CTO）患者冠状动脉侧支循环（CC）方面的价值。

方法

计算1409例T2DM合并CTO患者入院时的全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）和全免疫炎症值（PIV）。采用Rentrop评分系统评估冠状动脉侧支程度，分为侧支循环不良（Rentrop评分0或1）或侧支循环良好（Rentrop评分2或3）。通过多因素回归分析确定侧支循环不良的预测因素，并通过受试者工作特征（ROC）曲线分析这些指标的诊断潜力。

结果

SII、SIRI和PIV水平在Rentrop评分0 - 3之间逐步升高，侧支循环不良患者的水平显著高于侧支循环良好患者（<0.001）。校正混杂因素后，SII、SIRI和PIV（按三分位数）仍是侧支循环不良的独立因素。SII对侧支循环不良的预测优于SIRI和PIV（AUC：0.758 vs. 0.680和0.698，均<0.001）。糖化血红蛋白（HbA1c）血浓度与SII之间存在交互作用（<0.001），与HbA1c≥6.5%的患者相比，HbA1c<6.5%的患者中，高SII水平与更高风险相关（OR：5.058 vs. 2.444），且对侧支循环不良具有更好的预测能力（AUC：0.817 vs. 0.731）。