Prognostic significance of pan-immune-inflammatory value in adverse cardiovascular and cerebrovascular events post-percutaneous coronary intervention in diabetic patients with coronary heart disease

Background The pan-immune-inflammation value (PIV) is a novel biomarker reflecting systemic inflammation. Its role in predicting adverse cardiovascular and cerebrovascular events in diabetic patients after percutaneous coronary intervention (PCI) is unclear. Objectives This study evaluated PIV's prognostic value for major adverse cardiovascular and cerebrovascular events (MACCE) post-PCI in diabetics with coronary heart disease (CHD), and compared it to other inflammation-based markers like systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Methods Retrospective analysis of diabetic CHD patients undergoing PCI. PIV was calculated as (neutrophil × platelet × monocyte)/lymphocyte counts from pre-procedural blood. Optimal cutoff determined via ROC curve. Patients stratified into high/low PIV groups. Follow-up for MACCE (e.g., MI, stroke, revascularization). Kaplan–Meier (KM) survival, Cox regression, and ROC comparisons assessed outcomes. Results Over 24-month median follow-up, 52 MACCE occurred (24.8%). High-PIV group had higher incidence (37.7% vs. 11.5%, p < 0.001) and worse MACCE-free survival (log-rank p < 0.001). Multivariate Cox confirmed high PIV as independent predictor (adjusted HR = 2.87, 95% CI: 1.55–5.32, p = 0.001). PIV AUC = 0.74 (95% CI: 0.68–0.80), outperforming SII (0.69), NLR (0.66), and PLR (0.64; DeLong's test p < 0.05 vs. NLR/PLR). Conclusions PIV is a robust, independent predictor of MACCE post-PCI in diabetics, with superior accuracy over other markers. It offers cost-effective risk stratification. Limitations: retrospective design; prospective validation needed.