Relationship Between Systemic Inflammation Index and No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction

Abstract

This study aimed to evaluate the relationship between no-reflow phenomenon and systemic inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil–lymphocyte ratio (NLR), and the platelet–lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI). A total of 785 patients were included. The thrombolysis in myocardial infarction (TIMI) flow degree has been used to describe the no-reflow phenomenon. The study population was divided into two groups regarding the presence of no-reflow phenomenon including 110 patients with no-reflow (TIMI frame count 0-2) and 675 patients without no-reflow (TIMI frame count 3). The NLR [6.6 (4.6-11.6) vs 3.2 (2.0-5.3); P < .001], PLR [175 (121.3-220) vs 102.6 (76.1-150.1); P < .001] and SII [1921(1225-2906) vs 738.5 (450.5-1293); P < .001] were significantly higher in the no-reflow group. High NLR (OR: 1.078, 95%CI: 1.027-1.397; P = .021), PLR (OR: 1.009, 95%CI: 1.003-1.021; P = .041) and SII (OR: 1.216, 95%CI: 1.106-1.942; P = .004) were found to be independently associated with no-reflow phenomenon. The comparison of the receiver-operating characteristic curves showed that area under the curve of SII was greater than that of NLR (.789 vs .766, P = .007) and PLR (.789 vs .759, P = .048). SII levels may predict no-reflow phenomenon better than NLR and PLR.

Letter: Predictive Value of Systemic Immune-Inflammatory Index in No-Reflow in Patients with ST-Segment Elevation Myocardial Infarction

“…However, few studies have investigated the relationship between SII and no-reflow. An article 6 reported that SII may be a promising indicator for the prediction of no-reflow in patients with STEMI; this is consistent with the conclusions made by Çelik et al 1 We have some comments regarding the article by Çelik et al 1 They should provide medication information because drugs (eg, ticagrelor and clopidogrel) can affect the SII. 7 In Çelik's article, although multivariable regression analysis suggested that SII has great statistical significance, the odds ratio (OR) was relatively small (OR = 1.212).…”

“…7 In Çelik's article, although multivariable regression analysis suggested that SII has great statistical significance, the odds ratio (OR) was relatively small (OR = 1.212). 1 Besides, the predictive ability of SII was not significantly different from that of NLR (.789 vs .766) or PLR (.789 vs .759). 1 The mechanisms by which SII may participate in the noreflow phenomenon remain unclear.…”

“…1 Besides, the predictive ability of SII was not significantly different from that of NLR (.789 vs .766) or PLR (.789 vs .759). 1 The mechanisms by which SII may participate in the noreflow phenomenon remain unclear. SII may participate in neutrophil accumulation, reactive oxygen species generation, and endothelial dysfunction.…”

“…They reported that the ability of SII to predict no-reflow was stronger than that of NLR and PLR. 1 SII, a novel inflammation and immune marker defined as platelet count ×neutrophil count/lymphocyte counts, was proposed by Hu et al and was found to have a prognostic value in different types of cancer. 2 In recent years, its role in cardiovascular (CV) disease has attracted attention.…”

“…We read with interest the article entitled “Relationship between systemic inflammation index and no-reflow phenomenon in patients with ST-segment elevation myocardial infarction” by Celik et al 1 We congratulate the authors and would like to discuss some points regarding the systemic immune-inflammatory index (SII) and no-reflow.…”