Key result
Higher admission SIPS fails to independently predict angiographic no-reflow risk after adjustment.
Why the study?
No-reflow is a serious complication of PPCI in STEMI, and whether the Scottish Inflammatory Prognostic Score (SIPS) is associated with angiographic no-reflow had not been tested.
Does the admission Scottish Inflammatory Prognostic Score predict angiographic no-reflow in STEMI patients undergoing PPCI?
Observational (n=1,018)
Does the admission Scottish Inflammatory Prognostic Score predict angiographic no-reflow in STEMI patients undergoing PPCI?
Absolute Event Rate: 16.5% vs 10.2%
p-value: p=.022
While admission SIPS is univariately associated with no-reflow in STEMI patients undergoing PPCI, it does not independently predict this complication after adjusting for factors like diabetes.
Admission SIPS should not yet inform no-reflow risk assessment in STEMI PPCI; hypothesis-generating for inflammatory scores beyond diabetes.
No-reflow is a serious complication of PPCI in STEMI. Systemic inflammation plays a role, but simple prognostic tools are needed. The Scottish Inflammatory Prognostic Score (SIPS), combining neutrophil count and serum albumin, shows promise in other areas but hasn’t been tested for no-reflow. The present study aimed to investigate the association between admission SIPS and angiographic no-reflow in STEMI patients undergoing PPCI. One thousand eighteen consecutive STEMI patients undergoing PPCI between 2020 and 2025 were analysed. SIPS was calculated on admission. No-reflow was defined as post-procedural thrombolysis in myocardial infarction (TIMI) flow <3 without mechanical obstruction. Associations were assessed using chi-square, receiver operating characteristic (ROC) analysis, and multivariate logistic regression. No-reflow occurred in 132 patients (13.0%), increasing with SIPS: 10.2% (low), 15.9% (moderate), 16.5% (high; P = .022). SIPS had modest discriminative ability (area under Curve [AUC] = 0.563, P = .019), similar to neutrophil count. Diabetes was independently linked to no-reflow (OR 1.30, P = .032); SIPS categories were not. Higher admission SIPS was associated with increased no-reflow risk in a graded pattern but did not emerge as an independent predictor after multivariable adjustment. DM was the sole independent predictor identified.
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Aydın et al. (2026) conducted an observational in ST-Segment Elevation Myocardial Infarction (n=1,018). Scottish Inflammatory Prognostic Score (SIPS) vs. Low SIPS category was evaluated on Angiographic no-reflow (post-procedural TIMI flow <3 without mechanical obstruction) (p=.022). Higher admission Scottish Inflammatory Prognostic Score was associated with increased no-reflow risk (16.5% high vs 10.2% low; P=0.022) but was not an independent predictor after adjustment.
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