Systemic immune-inflammation index and in-stent restenosis in patients with acute coronary syndrome: a single-center retrospective study

Abstract

Background In-stent restenosis (ISR) has been shown to be correlated with inflammation. This study aimed to examine the relationship between systemic immune-inflammation index (SII, an innovative inflammatory biomarker) and ISR in acute coronary syndrome (ACS) patients after drug-eluting stent (DES) implantation. Methods Subjects who were diagnosed with ACS and underwent DES implantation were enrolled retrospectively. All individuals underwent follow-up coronary angiography at six to forty-eight months after percutaneous coronary intervention (PCI). SII was defined as [(platelet count × neutrophil count)/lymphocyte count], and Ln-transformed SII (LnSII) was carried out for our analysis. Multivariate logistic regression analysis was employed to assess the association between LnSII and DES-ISR. Results During a median follow-up period of 12 (11, 20) months, 523 ACS patients who underwent follow-up angiography were included. The incidence of DES-ISR was 11.28%, and patients in the higher LnSII tertile trended to show higher likelihoods of ISR (5.7% vs. 12.1% vs. 16.0%; P = 0.009). Moreover, each unit of increased LnSII was correlated with a 69% increased risk of DES-ISR (OR = 1.69, 95% CI 1.04–2.75). After final adjusting for confounders, a significant higher risk of DES-ISR (OR = 2.52, 95% CI 1.23–5.17) was found in participants in tertile 3 (≥ 6.7), compared with those in tertiles 1–2 (< 6.7). Subgroup analysis showed no significant dependence on age, gender, body mass index, current smoking, hypertension, and diabetes for this positive association (all P for interaction > 0.05). Conclusion High levels of SII were independently associated with an increased risk of DES-ISR in ACS patients who underwent PCI. Further prospective cohort studies are still needed to validate our findings.

Usefulness of the Systemic Inflammation Response Index and the Systemic Immune Inflammation Index in Predicting Restenosis After Stent Implantation

“…6 , 7 , 37 , 38 Two recent studies on the relationship between SII and ISR suggest that SII is independently associated with an increased risk of ISR after PCI in patients with acute coronary syndrome and may serve as an independent predictive indicator of ISR. 19 , 20 In our study, we found a strong association between high SIRI and SII levels and ISR, further confirming the possible link between systemic inflammation and the occurrence and development of ISR. We hypothesize that SIRI and SII may trigger inflammation and oxidative stress, leading to endothelial dysfunction and subsequent ISR.…”

“…Two recent studies have shown that a higher SII is independently associated with an increased risk of ISR after PCI in patients with acute coronary syndrome, and may be a predictive indicator of ISR. 19 , 20 There is still a lack of effective evidence for the association between SIRI and ISR. The aim of this study was to investigate the associations of SIRI and SII with ISR in patients with coronary artery disease undergoing PCI and to evaluate the predictive value of these two indicators for ISR.…”