High systemic immune-inflammation index is associated with carotid plaque vulnerability: New findings based on carotid ultrasound imaging in patients with acute ischemic stroke

Abstract

Vulnerable carotid plaque is closely related to the occurrence of Ischemic stroke. Therefore, accurate and rapid identification of the nature of carotid plaques is essential. AS is a chronic immune inflammatory process. Systemic immune-inflammation index (SII) is a novel index of immune inflammation obtained from routine whole blood cell count analysis, which comprehensively reflects the state of inflammation and immune balance in the body. This study sought to explore the relationship between SII level and carotid plaque vulnerability, plaque composition characteristics, and acute ischemic stroke (AIS) severity. A total of 131 patients diagnosed with AIS presenting with a carotid atherosclerotic plaque were enrolled in this study. Using carotid ultrasound (CDU) to assess the carotid-responsible plaque properties, we divided the patients into stable plaques group and vulnerable plaques group, and analyzed the correlation between SII levels and plaque vulnerability. And we further analyzed to evaluate the correlation between high SII levels and plaque characteristics and AIS severity. In addition, Cohen's Kappa statistics was used to detect the consistency of Carotid ultrasound (US) and cervical High-resolution magnetic resonance imaging (HRMRI) in evaluating plaque vulnerability. The findings showed that the vulnerable group had higher levels of SII compared with the stable group. The high SII group had more vulnerable plaques and a high frequency of plaque fibrous cap rupture compared with the low SII group. Logistic analysis showed that a high SII level was an independent risk factor for vulnerable plaques (odds ratio [OR] = 2.242) and plaque fibrous cap rupture (OR=3.462). The results also showed a high consistency between Carotid US and HRMRI methods in the assessment of plaque vulnerability [Cohen's kappa value was 0.89 (95% CI = 0.78–0.97)] and the level of SII was positively associated with NIHSS score (r = 0.473, P < 0.001). Our study suggests that elevated levels of SII may have adverse effects on the vulnerability of carotid plaques, especially in stroke patients with vulnerable plaques with ruptured fibrous caps, which may aggravate the severity of AIS.

Association of systemic immune-inflammation index with diabetic kidney disease in patients with type 2 diabetes: a cross-sectional study in Chinese population

“…Moreover, partial correlation analysis controlling for sex, age, BMI, and duration of diabetes demonstrated that SII was positively associated with apoB/A, FBG, PBG, HbA1c, GE index, poor glycaemic control, METS-IR, and inversely correlated with TC and HDL-C, suggesting that SII might be correlated with metabolic disorders, especially IR, hyperglycemia, and dyslipidaemia, and metabolic disorders might at least partially mediate the relationship between SII and DKD. Our findings were consistent with previous studies that reported the potential relationship between SII and metabolic disorders (70)(71)(72)(73)(74)(75)(76)(77)(78)(79). Some studies have demonstrated that the subjects with the highest quartile of SII have significantly higher homeostatic model assessment index of IR (HOMA-IR) than those with the lower quartiles in perimenopausal and postmenopausal women (70, 71), and the U.S. general population (72), and SII was positively associated with HOMA-IR in children with obesity (15).…”

Increased Serum Systemic Immune-Inflammation Index is Independently Associated With Severity of Carotid Artery Stenosis

“…In patients with HT, Çırakoğlu et al 45 demonstrated that SII is an independent predictor of increased carotid intima-media thickness. Zhang et al 46 showed a relationship between SII and vulnerable plaques in patients with acute ischemic stroke. Keskin et al 12 demonstrated that in stented patients receiving treatment for CAS, SII could be independently linked with short- and long-term clinical outcomes.…”

Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV

“…Moreover, Zhang’s study showed that a high SII may adversely affect carotid plaque vulnerability. Specifically, patients with fragile plaques with burst fibrous caps may experience a considerable impact, which might worsen the severity of AIS ( 35 ). A previous study based on the MIMIC-IV database showed that a high SII increased 30-day all-cause mortality ( 36 ).…”