What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Patients with myocardial infarction mainly undergoing percutaneous coronary intervention (PCI) (n=16054). Intervention: High systemic inflammation response index (SIRI) vs. Low SIRI. Primary outcome: All-cause mortality (RR 2.73, 95% CI 1.82 to 4.10, p=<0.00001).

What question did this study set out to answer?

This research aims to assess how well the systemic inflammation response index predicts outcomes in myocardial infarction patients.

March 2, 2026Open Access

Prognostic value of systemic inflammation response index in patients with myocardial infarction: a systematic review and meta-analysis

Q: What are the key findings of this study?

High systemic inflammation response index (SIRI) increased all-cause mortality risk by 173% (RR 2.73, 95% CI 1.82-4.10, P < 0.00001) in myocardial infarction patients.

Q: What question did this study set out to answer?

This research aims to assess how well the systemic inflammation response index predicts outcomes in myocardial infarction patients.

Key Result

High systemic inflammation response index (SIRI) increased all-cause mortality risk by 173% (RR 2.73, 95% CI 1.82-4.10, P < 0.00001) in myocardial infarction patients.

Key Points

This research aims to assess how well the systemic inflammation response index predicts outcomes in myocardial infarction patients.
Conducted a systematic review and meta-analysis of literature from PubMed, Embase, Web of Science, and Cochrane until January 2026.
Analyzed mortality and major adverse cardiovascular events as key outcomes.
Calculated risk ratios and confidence intervals for data synthesis.
Performed sensitivity and subgroup analyses to evaluate result stability and heterogeneity.
Used the trim-and-fill method to address publication bias.
Identified 13 studies involving 16,054 myocardial infarction patients.
Higher SIRI is associated with a significantly increased risk of mortality (RR: 2.73) and major adverse cardiovascular events (RR: 1.54).
Sensitivity analysis confirmed SIRI's reliability in predicting mortality and MACE.
Subgroup analysis showed that the SIRI cut-off value was a major source of variability in results.

Study Design

Type

Meta-Analysis (n=16,054)

Structured PICO

Does a high systemic inflammation response index (SIRI) predict increased mortality and MACE in patients with myocardial infarction?

Population

13 cohort studies involving 16,054 myocardial infarction (MI) patients, primarily those who underwent interventional treatment (PCI).

Intervention

High systemic inflammation response index (SIRI)

Comparator

Low systemic inflammation response index (SIRI)

Outcome

Mortality and major adverse cardiovascular events (MACE)hard clinical

SIRI is a readily available composite inflammatory marker that effectively predicts mortality and MACE in patients with myocardial infarction.

Main Result

Effect estimate: RR 2.73 (95% CI 1.82 to 4.10)

p-value: p=<0.00001

Limitations

Included studies primarily retrospective cohort design with potential for confounding and bias
Majority of studies from Asia with limited geographic diversity, limiting generalizability
Significant heterogeneity observed in results for mortality and MACE (I2 > 80%)
Variability in SIRI cutoff values across studies contributed to heterogeneity
Potential publication bias detected for MACE but not for mortality
Lack of standardized timing for SIRI measurement and variations in endpoint definitions
Insufficient data to analyze specific components of MACE
Unable to fully quantify contributions to heterogeneity due to limited original study data

Abstract

This study evaluates the prognostic value of the systemic inflammation response index (SIRI) in myocardial infarction (MI) patients. PubMed, Embase, Web of Science, and Cochrane were used to search literature through January 2026, focusing on mortality and major adverse cardiovascular events (MACE) as outcomes. Risk ratios (RR) and 95% confidence intervals (CI) were used for data synthesis. Sensitivity and subgroup analyses assessed result stability and identified potential sources of heterogeneity. For results with publication bias, the trim-and-fill method was used to assess its impact on the results. Thirteen studies involving 16,054 MI patients were included. Higher SIRI linked with an increased risk of mortality (RR: 2.73; 95% CI: 1.82, 4.10; P < 0.00001) and MACE (RR: 1.54; 95% CI: 1.37, 1.73; P < 0.00001) in MI patients. Sensitivity analysis confirmed the stability of SIRI as a predictor for both mortality and MACE. Subgroup analysis indicated that the SIRI cut-off value was the primary contributor to the significant heterogeneity observed in mortality and MACE. SIRI can effectively predict mortality and MACE in MI patients, identifying those at high risk early for targeted intervention. Larger, multicenter, prospective cohort studies are required to further evaluate its prognostic value in MI patients.

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Cite This Study

Lei et al. (Sat,) conducted a meta-analysis in Patients with myocardial infarction mainly undergoing percutaneous coronary intervention (PCI) (n=16,054). High systemic inflammation response index (SIRI) vs. Low SIRI was evaluated on All-cause mortality (RR 2.73, 95% CI 1.82 to 4.10, p=<0.00001). High systemic inflammation response index (SIRI) increased all-cause mortality risk by 173% (RR 2.73, 95% CI 1.82-4.10, P < 0.00001) in myocardial infarction patients.

synapsesocial.com/papers/69a52e56f1e85e5c73bf1e41 https://doi.org/https://doi.org/10.1186/s12872-026-05633-y

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