Akut koroner sendromda akut stent trombozunun ve hastane içi mortalitenin yeni bir inflamasyon göstergesi: çoklu inflamasyon indeksi

Abstract

Aim: The inflammatory milieu plays a triggering role in the development of acute stent thrombosis (ST), which occurs as a catastrophic complication following percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). This study aimed to investigate the prognostic role of multi-inflammatory index (MII), a powerful new marker of inflammation, in predicting of high SYNTAX score, acute ST and in-hospital mortality in patients with ACS undergoing PCI.
 Material and Method: This retrospective study included 1488 consecutive patients with ACS undergoing PCI, and definitive ST was determined according to Academic Research Consortium criteria. Inflammation indices were calculated as follows: Systemic immune inflammation (SII)=neutrophil×platelet/lymphocyte ratio, CAR=CRP/albumin ratio, MII-1=platelet×CRP/lymphocyte ratio, MII-2=neutrophil×CRP/lymphocyte ratio, MII-3=SII×CRP.
 Results: The incidence of acute ST was 3.6%. All inflammation indices was higher in the acute ST group and high SYNTAX score group. Multivariable regression analysis showed that MII-3 independent predictors of acute ST and high SYNTAX score. MII-3 exhibited better diagnostic performance than other inflammatory indices. The threshold value of MII-3 in predicting acute ST was >9084 (AUC=0.842, sensitivity=87.3%, specificity=%77.8) and patients with MII-3 >9084 had a 3.73-fold greater risk of mortality. 
 Conclusion: MII-3 is a stronger predictor of acute ST following PCI and it is associated with an increased risk of mortality. MII may be an essential prognostic screening tool for identifying high-risk patients prior to procedure.

Relationship between systemic inflammation indices and time of symptom onset in cardiac remodeling after first ST-segment elevation myocardial infarction

“…The SIRI was found to be an independent predictor of LVAR and showed superior diagnostic performance compared to the SII index. Previous studies demonstrated that increased SII index and SIRI were important predictors of cardiovascular events [12][13][14]. Increased SII index and SIRI were related to increased risk of LVAR in patients experiencing STEMI for the first time.…”

“…Therefore, given the potential role of increased IIR in the development of LVAR after acute MI, we hypothesized that there might be an association between leukocyte-based inflammatory indices and the circadian clock. Among these indices, we evaluated the systemic immune inflammation (SII) index and systemic inflammation response index (SIRI), which have not yet been investigated in the context of LVAR but are claimed to have better prognostic roles in predicting cardiovascular events including acute MI [12][13][14]. The SII index, which is an indicator of inflammatory status, is calculated by platelet count × neutrophil count/lymphocyte count [15], while the SIRI, which is an indicator of the balance between the inflammatory response and immune status, is calculated by neutrophil count × monocyte count/lymphocyte count [16].…”