What is the clinical evidence from this study?

Study design: Cohort. Population: Chronic coronary syndrome (CCS) (n=278). Intervention: Systemic Inflammatory Response Index (SIRI) and Epicardial Adipose Tissue (EAT). Primary outcome: Major adverse cardiovascular events (MACEs) (HR 1.14, 95% CI 1.08-1.21, p=<0.001).

November 1, 2025Journal of Inflammation Research1 citationsOpen Access

Chronic Inflammation in Patients with Chronic Coronary Syndrome Who Have Been Taking Lipid-Lowering Drugs as a Residual Risk Factor – a Bidirectional Synergistic Correlation with Epicardial Adipose Tissue

Q: What are the key findings of this study?

In patients with chronic coronary syndrome on long-term statin therapy, elevated Systemic Inflammatory Response Index (HR 1.14) and increased epicardial adipose tissue volume (HR 1.02) were independently associated with an increased risk of major adverse cardiovascular events.

RZRunze ZhuShandong Provincial Hospital WWWenxian WangBinzhou Medical University YGYan GaoZhejiang Normal University

Key Result

In patients with chronic coronary syndrome on long-term statin therapy, elevated Systemic Inflammatory Response Index (HR 1.14) and increased epicardial adipose tissue volume (HR 1.02) were independently associated with an increased risk of major adverse cardiovascular events.

Study Design

Type

Cohort (n=278)

Multicenter

Yes

Structured PICO

Population

410 patients with chronic coronary syndrome (CCS) on long-term statin therapy, median age 59, 71% male, from two medical institutions in China. Key inclusion: hospitalized for ACS or coronary revascularization and discharged after achieving clinical stability.

Outcome

Composite of cardiovascular death, myocardial infarction, stroke, rehospitalization for unstable angina requiring hospitalization or revascularization, heart failure, and ventricular arrhythmias (VAs)composite

In patients with chronic coronary syndrome on long-term statin therapy, elevated systemic inflammation and epicardial adipose tissue volume are synergistic residual risk factors for adverse cardiovascular events.

Main Result

Effect estimate: HR 1.14 (95% CI 1.08-1.21)

p-value: p=<0.001

Limitations

Unable to determine the temporal sequence of their occurrence
Relatively small sample size may lead to insufficient statistical power
Use of a composite endpoint indicator that includes ventricular arrhythmias
Patients' withdrawal behavior may be related to their health conditions, introducing biases
Potential influence of unmeasured confounders
Unable to conduct quantitative measurements of the pericoronary adipose tissue

Abstract

Background: Patients with coronary heart disease on long-term lipid-lowering agents typically maintain relatively low lipid levels. However, an elevated systemic inflammatory state represents another major risk factor for poor prognosis in these individuals. This study aims to investigate the relationship between systemic inflammation and adverse outcomes in patients with chronic coronary syndrome(CCS), as well as its synergistic interaction with epicardial adipose tissue (EAT). Methods: This is a double-center retrospective cohort study. From March 2017 to September 2023, We retrospectively included 278 patients with CCS from two medical institutions in China, all of whom had been receiving long-term statin therapy. Participants underwent cardiovascular magnetic resonance (CMR) imaging and blood testing. Systemic inflammatory response index (SIRI) were derived, and CMR parameters, including EAT volume, were measured. Cox regression analysis was used to evaluate the association between each variable and major adverse cardiovascular events (MACEs). Mediation analysis was applied to assess the interrelationships among systemic inflammatory markers, indexed EAT volume, and CMR parameters. Results: Both the SIRI and indexed EAT volume were independently associated with MACEs. Combining SIRI and indexed EAT volume significantly improved the predictive capacity for MACEs. EAT volume partially mediated the relationship between SIRI and MACEs, and similarly, SIRI partially mediated the association between EAT volume and MACEs. Additionally, we observed analogous interrelationships among SIRI, indexed EAT volume, and extracellular volume (ECV). Conclusion: In patients with CCS on long-term statin therapy, elevated SIRI and increased EAT volume represent more important risk factors than lipid levels. SIRI and EAT volume interact with each other and collectively contribute to a poor prognosis in these patients.

Ask AI

Helpful

Bookmark

View Full Paper