Oflar Ersan, Kalyoncuoğlu Muhsin, Koyuncu Atilla, Yıldız Erbaş Cennet, Sinoplu Hasan Ali, Katkat Fahrettin, Durmuş Gündüz
Department of Cardiology, Bakırköy Sadi Konuk Training and Research Hospital, University of Health Sciences, 34147 Istanbul, Turkey.
Department of Cardiology, Istanbul Training and Research Hospital, University of Health Sciences, 34098 Istanbul, Turkey.
J Clin Med. 2025 Jun 25;14(13):4491. doi: 10.3390/jcm14134491.
To evaluate the prognostic role of the inflammatory prognostic index (IPI) value at admission in major adverse cardiovascular and cerebrovascular events (MACCEs) in individuals with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). A total of 1142 NSTEMI patients with a mean age of 61.9 ± 12.5 years were included. Admission C-reactive protein level, serum albumin level, and complete blood counts of participants were collected from hospital records. The IPI was calculated based on the following formula: C-reactive protein/albumin ratio (CAR) x neutrophil-to-lymphocyte ratio (NLR). An aggregate index of systemic inflammation (AISI) value was calculated using the ''neutrophil count x monocyte count x platelet/lymphocyte count'' formula. The study cohort was divided into two groups according to the median IPI value. Patients with higher IPI values were statistically more likely to suffer from MACCEs within one year ( < 0.001), thus the admission IPI value was found to be associated with future development of MACCEs. Furthermore, it had sufficient discrimination power (AUC = 0.70) and predictive accuracy in identifying MACCEs compared to other inflammatory parameters such as the CAR (AUC = 0.64), the NLR (AUC = 0.64), and the AISI (AUC = 0.59). Adding the IPI to the baseline multivariable logistic regression model significantly improved the model's discrimination and net clinical benefit effect for identifying patients who would suffer from MACCEs, with a C-index of 0.84 (95% CI: 0.82-0.86) and explanatory power of 23.2% (R = 0.232, DeLong test = 0.001). High-risk patients with an IPI value greater than 2.43 had significantly more adverse events ( < 0.001). The IPI may be a promising inflammatory index for use in clinical practice to determine the risk prediction of MACCEs in NSTEMI patients undergoing PCI.
为评估炎症预后指数（IPI）值在接受经皮冠状动脉介入治疗（PCI）的非ST段抬高型心肌梗死（NSTEMI）患者发生主要不良心血管和脑血管事件（MACCEs）中的预后作用。共纳入1142例平均年龄为61.9±12.5岁的NSTEMI患者。从医院记录中收集参与者的入院C反应蛋白水平、血清白蛋白水平和全血细胞计数。IPI根据以下公式计算：C反应蛋白/白蛋白比值（CAR）×中性粒细胞与淋巴细胞比值（NLR）。使用“中性粒细胞计数×单核细胞计数×血小板/淋巴细胞计数”公式计算全身炎症综合指数（AISI）值。根据IPI值中位数将研究队列分为两组。IPI值较高的患者在一年内发生MACCEs的可能性在统计学上更高（<0.001），因此发现入院IPI值与MACCEs的未来发生相关。此外，与其他炎症参数如CAR（AUC=0.64）、NLR（AUC=0.64）和AISI（AUC=0.59）相比，它在识别MACCEs方面具有足够的辨别力（AUC=0.70）和预测准确性。将IPI添加到基线多变量逻辑回归模型中，显著提高了模型对识别将发生MACCEs患者的辨别力和净临床效益，C指数为0.84（95%CI：0.82-0.86），解释力为23.2%（R=0.232，德龙检验=0.001）。IPI值大于2.43的高危患者不良事件明显更多（<0.001）。IPI可能是一种有前景的炎症指标，可用于临床实践中确定接受PCI的NSTEMI患者发生MACCEs的风险预测。
