Key result
High cumulative systemic immune-inflammation index linked to ~9% higher MACE risk in post-PCI STEMI.
Why the study?
Little evidence exists on the relationship between the systemic immune-inflammation index (SII) and long-term prognosis after myocardial infarction.
Does a high cumulative systemic immune-inflammation index (SII) predict major adverse cardiovascular events (MACE) in STEMI patients after PCI?
Observational (n=480)
No
Does a high cumulative systemic immune-inflammation index (SII) predict major adverse cardiovascular events (MACE) in STEMI patients after PCI?
Long-term cumulative exposure to a high systemic immune-inflammation index increases the risk of MACE in STEMI patients after PCI, highlighting the prognostic value of monitoring and controlling late inflammation.
High cumulative SII was associated with higher MACE risk post-STEMI PCI; leaves open whether targeting inflammation improves outcomes.
The systemic immune-inflammation index (SII) has been used effectively to effectively assess the prognosis of patients with a variety of diseases. But few evidence on the relationship between SII and long-term prognosis of myocardial infarction. We thus aimed to evaluate the relationships of cumulative exposure to SII and its accumulation time course with major adverse cardiovascular events (MACE) events in patients with acute myocardial infarction after percutaneous coronary intervention. To evaluate the predictive value of SII in MACE events in patients with acute myocardial infarction. A total of 480 patients with acute ST-elevation myocardial infarction who underwent emergency coronary angiography at the Department of Cardiology, Affiliated Hospital of Hebei University from August 2022 to August 2023 were enrolled in this study. Eighteen patients were lost to follow-up, with a loss rate of 3.8%. Time-weighted cumulative SII was calculated as the weighted sum of the mean SII value for each time interval, then normalized by total exposure duration, the exposure duration was from hospitalization to 1-year follow-up. Duration of high SII exposure was defined as the duration with high SII and ranged from hospitalization to 1-year follow-up. The time course of SII accumulation was categorized by the combination of time-weighted cumulative SII < or ≥ median and SII slope. At 1-year follow-up, after adjusting for potential confounders, the time-weighted cumulative SII was divided into 2 groups. The S2 group which is above the median had a higher risk of MACE (hazard ratio, 1.090; 95% confidence interval 1.035-1.149), the high time-weighted cumulative SII group with a positive slope had a higher risk of MACE (hazard ratio, 4.096; 95% confidence interval 1.851-9.065). Long-term cumulative exposure to SII increases the risk of MACE in patients with acute ST-elevation myocardial infarction undergoing coronary angiography, and late high SII results in a higher risk of MACE events at the same time-weighted cumulative SII, underscoring the importance of late inflammation control.
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Zhang et al. (2025) conducted an observational in Acute ST-elevation myocardial infarction (STEMI) (n=480). High time-weighted cumulative systemic immune-inflammation index (SII ≥ median) vs. Low time-weighted cumulative SII (< median) was evaluated on Major adverse cardiovascular events (MACE) (HR 1.090, 95% CI 1.035-1.149, p=0.029). High time-weighted cumulative systemic immune-inflammation index above the median increased the risk of major adverse cardiovascular events (HR 1.090) in patients with acute STEMI after percutaneous coronary intervention.
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