Li Sicong, Gao Luyang, Zhang Sicheng, Zhao Qing, Yang Tao, Duan Anqi, Wang Yijia, Wang Qi, Zhao Zhihui, Luo Qin, Liu Zhihong
Center for Respiratory and Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.
J Inflamm Res. 2025 Jun 21;18:8217-8231. doi: 10.2147/JIR.S517285. eCollection 2025.
Composite inflammatory markers, such as the systemic inflammatory response index (SIRI), are associated with the severity and progression of several cardiovascular diseases. However, the relationship between SIRI and chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. We hypothesized that elevated SIRI levels would correlate with disease severity and independently predict adverse clinical outcomes in patients with CTEPH. This study aimed to clarify the predictive value of SIRI in patients with CTEPH.
This retrospective cohort study included 383 patients with CTEPH treated at Fuwai Hospital between June 2013 and June 2021. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic performance of SIRI to other inflammatory indices and identify the optimal cutoff value. Kaplan-Meier analysis and Cox proportional hazard models were used to examine the relationship between SIRI and clinical worsening.
During a mean follow-up period of 30.6 months, 79 participants experienced clinical worsening. The SIRI was significantly correlated with established markers of CTEPH severity, including the 6-minute walk distance, N-terminal pro-brain natriuretic peptide, and hemodynamic parameters. Kaplan-Meier curve revealed that individuals with a SIRI ≥ 0.80 exhibited significantly poorer survival rates and a shorter time to clinical worsening compared to those with a SIRI < 0.80 (P < 0.01). Adjusted Cox proportional hazards analysis revealed that SIRI remained an independent predictor of clinical worsening (hazard ratio (HR) 2.033; 95% confidence interval (CI) 1.227-3.370). ROC analysis revealed that SIRI exhibited the highest area under the curve value of 0.730 (95% CI 0.659-0.810). Incorporating SIRI into The COMPERA 2.0, the risk score improved its predictive value for adverse outcomes in patients with CTEPH.
SIRI is a valuable prognostic marker for CTEPH, correlating with established markers of disease severity and independently predicting clinical worsening. SIRI provides additional prognostic predictive value when used in conjunction with the risk score of COMPERA 2.0.
复合炎症标志物，如全身炎症反应指数（SIRI），与多种心血管疾病的严重程度和进展相关。然而，SIRI与慢性血栓栓塞性肺动脉高压（CTEPH）之间的关系仍不清楚。我们假设SIRI水平升高与疾病严重程度相关，并能独立预测CTEPH患者的不良临床结局。本研究旨在阐明SIRI对CTEPH患者的预测价值。
这项回顾性队列研究纳入了2013年6月至2021年6月在阜外医院接受治疗的383例CTEPH患者。采用受试者工作特征（ROC）曲线分析比较SIRI与其他炎症指标的诊断性能，并确定最佳截断值。采用Kaplan-Meier分析和Cox比例风险模型来研究SIRI与临床恶化之间的关系。
在平均30.6个月的随访期内，79名参与者出现临床恶化。SIRI与CTEPH严重程度的既定标志物显著相关，包括6分钟步行距离、N末端脑钠肽前体和血流动力学参数。Kaplan-Meier曲线显示，SIRI≥0.80的个体与SIRI<0.80的个体相比，生存率显著更低，临床恶化时间更短（P<0.01）。调整后的Cox比例风险分析显示，SIRI仍然是临床恶化的独立预测因素（风险比（HR）2.033；95%置信区间（CI）1.227-3.370）。ROC分析显示，SIRI的曲线下面积值最高，为0.730（95%CI 0.659-0.810）。将SIRI纳入COMPERA 2.0中，风险评分提高了其对CTEPH患者不良结局的预测价值。
SIRI是CTEPH的一个有价值的预后标志物，与疾病严重程度的既定标志物相关，并能独立预测临床恶化。当与COMPERA 2.0的风险评分联合使用时，SIRI提供了额外的预后预测价值。
