Could the systemic immune-inflammation index be a predictor to estimate cerebrovascular events in hypertensive patients?

Abstract

Background and objectives Hypertension is one of the most important risk factors for cardiovascular and cerebrovascular events. Inflammatory processes occupy an important place in the pathogenesis of hypertension. Many studies have studied inflammatory markers responsible for the onset of hypertension and organ damage. In this study, we investigated whether the systemic immune-inflammation index (SII) (platelet × neutrophil/lymphocyte), -one of the new inflammatory markers -can be used to predict cerebrovascular events in hypertensive patients.Methods Ambulatory blood pressure monitoring results between January 2019 and June 2020 of approximately 379 patients followed up with hypertension were retrospectively analyzed. These patients were divided into two groups as with or without a previous cerebrovascular event in the analyzed database. In all patients, complete blood count and biochemistry test results just before the cerebrovascular event were found from the database. SII, atherogenic index, neutrophil-lymphocyte ratio were calculated from the complete blood count. Fortynine patients with stroke (group 1: 12.9%; mean age: 64.3 ± 14.6) and 330 patients without stroke (group 2: 87.1%; mean age: 50.8 ± 14.4).Results Ambulatory blood pressure measurements were lower in group 1. Lipid parameters were also lower in this group. Receiver operating characteristic curve analysis showed that SII had a sensitivity of 85.7% and specificity of 84.8 % for stroke in individuals who participated in the study when the cutoff value of SII was 633.26 × 10 3 (P = 0.0001) area under curve (95%); 0.898 (0.856-0.941). In multivariate logistic regression analysis, age and SII were significantly associated with a higher risk of stroke. Age, (hazard ratio:1.067; 95% CI, 1.021-1.115), SII (hazard ratio:1.009; 95% CI, 1.000-1.009), respectively. ConclusionsIn conclusion, SII is a simple, useful new inflammatory parameter for predicting stroke from hypertension. We found that the high SII levels increase the risk of stroke in hypertensive patients.

Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: A systematic review and meta-analysis

“…Of the 152,996 participants, 102,822 were male and the mean/median age ranged from 33 to 70 years. The published studies were conducted in four regions: China ( 28 , 29 , 31 , 32 , 34 , 35 , 39 , 40 ), Turkey ( 30 , 33 , 38 ), Poland ( 36 ), and United States ( 37 ). The determination of SII cutoff values was based on ROC analysis, Youden index, and quartiles.…”

“…Except for cerebral small vessel disease (HR = 1.09, 95%CI: 0.95-1.25, P = 0.233), coronary heart disease (HR = 1.13, 95%CI: 0.94-1.36, P = 0.188), and venous thrombosis (HR = 4.65, 95%CI: 0.66-32.71, P = 0.122), there was a consistent statistical significance for the risk of ischemic stroke (HR = 1.31, 95%CI: 1.06-1.63, P = 0.013), hemorrhagic stroke (HR = 1.22, 95%CI: 1.10-1.37, P < 0.001), myocardial infarction (HR = 1.11, 95%CI: 1.01-1.23, P = 0.027), and peripheral arterial disease (HR = 1.51, 95%CI: 1.18-1.93, P = 0.001) (Table 2). Furthermore, nine studies reported differences in SII levels at the onset of CVD compared with the general population (28,30,(32)(33)(34)(36)(37)(38)(39), and all studies consistently suggested that SII levels at the onset of CVD were significantly higher than that in controls, with a median elevation range of 12-1,340. The random-effects model was used due to substantial heterogeneity (I 2 = 99.7%, P < 0.001), and the pooled WMD was 355.2 (95% CI: 234.8-475.6, P < 0.001) (Figure 2B), further confirming the correlation between SII and CVD development.…”

“…The pre-developed search strategy identified 2,664 records from PubMed, Embase, Web of Science, Cochrane library, and CINAHL databases. Based on the inclusion and exclusion criteria, a total of 13 studies were eligible for analysis (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). The flow diagram of the study selection process and exclusion reasons after full-reading are depicted in Figure 1.…”

Dynamic Status of SII and SIRI Alters the Risk of Cardiovascular Diseases: Evidence from Kailuan Cohort Study

“…The association between SII and SIRI at baseline and risk of CVD had been previously examined. [33][34][35] For example, Aydin et al found that higher SII level would increase the risk of stroke. 33 Jin et al concluded that higher SII and SIRI were associated with higher risk of developing CVD during a median follow-up period of 10 years.…”

Systemic immune inflammatory index is an independent predictor for the requirement of decompressive craniectomy in large artery occlusion acute ischemic stroke patients after mechanical thrombectomy

“…The systemic immune-inflammation index (SII), a new type of inflammatory index, is calculated by combining three immune inflammatory cells—lymphocytes, neutrophils, and platelets—and fully reflects the inflammation status ( 16 ). A high SII level increases the risk of stroke in patients with hypertension and affects patients' prognosis ( 17 ). Therefore, the purpose of our study was to calculate the SII according to the first routine blood test at admission, construct a model for the prediction of DC requirements, and verify the predictive value of the SII to provide a tool for the selection of DC in patients with LAO-AIS after MT.…”