Association of the systemic immune-inflammation index with all-cause mortality in patients with arteriosclerotic cardiovascular disease

Abstract

ObjectiveSystemic immune-inflammation index (SII), derived from blood cell counts of circulating platelets, neutrophils, and lymphocytes, has been identified as a novel inflammatory and prognostic marker. However, the clinical value of SII in patients with arteriosclerotic cardiovascular disease (ASCVD) had not been further explored. Thus, this study is designed to explore the associations of SII with mortality in ASCVD individuals.MethodsAll individuals with ASCVD aged ≥20 years were included from the National Health and Nutritional Examination Surveys (NHANES) 2005–2014 and followed for survival until 31 December 2019. Multivariable Cox analysis investigated the associations between SII, evaluated as a continuous variable with splines, as categorical ones (quartiles), and the all-cause death. To demonstrate the association between SII and mortality, subgroup analysis, restricted cubic spline along with piecewise linear regression were also conducted.ResultsA total of 2,595 participants (57.8% men) were included. During a median of 7.7 years of follow-up, 1,122 deaths due to all-cause were recorded. After adjusting for multiple confounders, when compared with the patients in quartile 1 (SII ln transform), those in quartile 4 had a 46% increased risk for all-cause death [hazard ratio (HR) = 1.46, 95% confidence interval (CI) = 1.22–1.75]. As a continuous variable, each unit of raised ln-SII was associated with a 24% increased risk of all-cause death (HR = 1.24, 95% CI = 1.10–1.38). In the restricted cubic spline regression model, the relationship between ln-SII and all-cause death was non-linear. The cutoff value of ln-SII for mortality was 6.57 and those with a higher than the threshold point had a 1.25-fold risk of mortality. No significant difference was noted below the threshold points.ConclusionAn association was detected between the baseline ln-SII and all-cause mortality in a United States ASCVD population. Increased SII is associated with poor survival in individuals with ASCVD.

Association between the systemic immune-inflammation index and kidney stone: A cross-sectional study of NHANES 2007-2018

“…SII was recognized as a valuable and convenient inflammatory biomarker to predict the risk of low bone mineral density or osteoporosis among postmenopausal women aged ≥ 50 years old ( 25 ). Moreover, SII has also been reported concerning all-cause mortality in arteriosclerotic cardiovascular disease ( 30 ).…”

The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999–2018

“…The study by Li et al [ 13 ] suggested that high SII levels may increase overall mortality and cardiovascular disease mortality in the general population, using NHANES follow-up data from 1999 to 2014. He et al [ 12 ] showed a correlation between SII and all-cause mortality in the US arteriosclerotic cardiovascular disease (ASCVD) population. Increased SII was associated with poor survival in ASCVD patients.…”

“…It is calculated using a formula that takes into account the levels of certain immune system markers in the blood, The calculation formula is platelets × neutrophils ÷ lymphocytes [ 11 ]. The SII is often used as a predictor of mortality in patients with tumors, as higher SII values have been associated with an increased risk of death [ 10 , 12 , 13 ]. This may be related to the imbalance between the body’s tumor-promoting and anti-tumor factors in the tumor state.…”

The systemic immune-inflammation index is associated with Type 2 diabetes mellitus patients: Evidence from NHANES 2011-2018

“…A cross-sectional study found that ln-SII at baseline was associated with all causes of death from any cause in the United States ASCVD population in the NHANES group [22]. Increased SII in ASCVD individuals is related to poor survival [23].In addition, higher levels of SII are related to an increased risk of hepatic steatosis[8], peripheral arterial disease [9], isolated coronary artery ectasia [10], urinary albuminuria excretion [5], diabetic kidney disease [11], and diabetic depression [12]. Likewise, T2DM patients were more likely to have elevated SII in our subgroup analysis compared with those who did not have T2DM, Indicating that in ammation may be signi cantly involved in developing T2DM.…”