Key result
High Inflammatory Prognostic Index linked to ~148% higher MACE risk following successful CTO-PCI.
Why the study?
The association between the Inflammatory Prognostic Index and long-term prognosis in patients with chronic total occlusion after successful PCI remained unclear.
Does a higher Inflammatory Prognostic Index (IPI) predict major adverse cardiovascular events in patients with chronic total occlusion undergoing successful PCI?
Cohort (n=525)
No
Does a higher Inflammatory Prognostic Index (IPI) predict major adverse cardiovascular events in patients with chronic total occlusion undergoing successful PCI?
Hazard Ratio: 2.484
p-value: p=<0.05
The Inflammatory Prognostic Index (IPI) is an independent, albeit modest, predictor of long-term major adverse cardiovascular events in patients with chronic total occlusion undergoing successful PCI.
IPI may refine post-PCI CTO risk assessment; extends CAD data but leaves incremental value open pending validation.
Accumulating evidence suggests that inflammatory and nutritional status play key roles in the prognosis of cardiovascular diseases (CVD). The Inflammatory Prognostic Index (IPI), integrating both inflammatory and nutritional metrics, has been linked to multiple subtypes of coronary artery disease (CAD). However, the association between IPI and long-term prognosis in patients with chronic total occlusion (CTO) after successful PCI remains unclear. Therefore, we aimed to investigate the prognostic role of IPI in patients with CTO who underwent successful PCI. A total of 525 patients with CTO who underwent successful PCI were enrolled in this study. Participants were stratified into a MACE group and a control group, as well as three subgroups (T1, T2, T3) by IPI tertiles. Baseline characteristics were compared, and Cox regression analysis were performed. The receiver operating characteristic curve (ROC) was used to determine the predictive value of IPI for major adverse cardiovascular events (MACE). A total of 76 patients with 82 MACE were recorded during the follow-up. Patients with MACE exhibited significantly higher C-reactive protein (CRP) and IPI levels ( p < 0.05). Patients in T3 (high IPI group) had higher white blood cell count, neutrophil count, CRP, creatinine, and IPI, while they had lower lymphocyte count, albumin (ALB), and left ventricular ejection fraction (LVEF) ( p < 0.05). In addition, patients in the highest IPI tertile exhibited a higher risk of target vessel revascularization (TVR) and composite MACE ( p < 0.05). Multivariate Cox regression analysis demonstrated that IPI was an independent predictor of MACE in patients with CTO who underwent successful PCI ( p < 0.05). Moreover, patients in the highest IPI tertile had a 2.484-fold higher risk of MACE ( p < 0.05). IPI may serve as a supplementary prognostic tool due to its simplicity and low cost. However, given its modest predictive performance, it should be combined with existing risk models to improve predictive value and facilitate clinical decision-making.
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Wu et al. (2026) conducted a cohort in Chronic total occlusion (CTO) (n=525). Inflammatory Prognostic Index (IPI) vs. Lower IPI tertiles was evaluated on Major adverse cardiovascular events (MACE), a composite of all-cause mortality, target vessel revascularization, and nonfatal myocardial infarction (HR 2.484, p=<0.05). Patients in the highest Inflammatory Prognostic Index tertile had a 2.484-fold increased risk of major adverse cardiovascular events compared to lower tertiles following successful CTO-PCI.
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