He Qian, Zhou Yun, Tong Xueying, Zhen Lei, Shi Shutian, Gong Wei, Nie Shaoping
Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China.
Cardiovascular Disease Treatment Center, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China.
J Inflamm Res. 2025 Jun 9;18:7515-7527. doi: 10.2147/JIR.S515437. eCollection 2025.
This study aimed to investigate the effects of the systemic inflammatory response index (SIRI) on the long-term prognosis of patients with acute coronary syndrome (ACS) and obstructive sleep apnea (OSA).
This prospective cohort study enrolled patients with ACS and OSA at the Beijing Anzhen Hospital between June 2015 and January 2020. The SIRI was calculated at admission for all patients. Patients with SIRI ≥ 1.16 × 10/L were classified into the high SIRI group based on the optimal cutoff value for predicting major adverse cardiovascular and cerebrovascular events (MACCE) determined by the receiver operating characteristic (ROC) curve of our cohort study. The other patients were categorized into the low SIRI group. The primary endpoint was a composite of MACCE, including cardiovascular death, recurrent myocardial infarction (MI), stroke, and ischemia-driven revascularization.
A total of 1011 patients with ACS and OSA were enrolled, 435 of whom (43%) were in the high SIRI group. Over a median follow-up of 2.8 (1.4-3.6) years, 179 patients experienced MACCE. Kaplan-Meier survival analysis showed a higher cumulative incidence of MACCE in the high-SIRI group (log-rank P < 0.001). A restricted cubic spline analysis also showed a monotonic increase with a greater SIRI value for MACCE (P = 0.011). After adjusting for clinically relevant confounders, a high SIRI was independently associated with elevated MACCE risk (adjusted HR = 1.44, 95% CI 1.02-2.05, P = 0.039).
A high SIRI was associated with poorer clinical outcomes during long-term follow-up in patients with ACS and OSA.
本研究旨在探讨全身炎症反应指数（SIRI）对急性冠状动脉综合征（ACS）合并阻塞性睡眠呼吸暂停（OSA）患者长期预后的影响。
本前瞻性队列研究纳入了2015年6月至2020年1月在北京安贞医院就诊的ACS合并OSA患者。所有患者在入院时计算SIRI。根据我们队列研究的受试者工作特征（ROC）曲线确定的预测主要不良心血管和脑血管事件（MACCE）的最佳临界值，将SIRI≥1.16×10/L的患者分为高SIRI组。其他患者分为低SIRI组。主要终点是MACCE的复合终点，包括心血管死亡、复发性心肌梗死（MI）、中风和缺血驱动的血运重建。
共纳入1011例ACS合并OSA患者，其中435例（43%）为高SIRI组。在中位随访2.8（1.4 - 3.6）年期间，179例患者发生MACCE。Kaplan-Meier生存分析显示，高SIRI组MACCE的累积发生率更高（对数秩检验P < 0.001）。受限立方样条分析也显示，MACCE的SIRI值越高，呈单调增加（P = 0.011）。在调整临床相关混杂因素后，高SIRI与MACCE风险升高独立相关（调整后HR = 1.44，95%CI 1.02 - 2.05，P = 0.039）。
高SIRI与ACS合并OSA患者长期随访期间较差的临床结局相关。
