Why the study?
Coronary no-reflow phenomenon after PCI in STEMI is linked to poor prognosis, prompting investigation into whether the systemic immune-inflammation index can aid early risk identification in older patients.
Does the systemic immune-inflammation index predict no-reflow phenomenon in older patients with STEMI undergoing primary PCI?
Does the systemic immune-inflammation index predict no-reflow phenomenon in older patients with STEMI undergoing primary PCI?
An elevated systemic immune-inflammation index (≥1814) can help identify older STEMI patients at high risk for no-reflow phenomenon during primary PCI.
May support SII for no-reflow risk stratification in older STEMI; hypothesis-generating and requires prospective validation before practice change.
Purpose: Coronary no-reflow phenomenon (NRP), a common adverse complication in patients with ST-segment elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI), is associated with poor patient prognosis. In this study, the correlation between the systemic immune-inflammation index (SII) and NRP in older patients with STEMI was studied, to provide a basis for early identification of high-risk patients and improve their prognosis. Materials and methods: Between January 2017 and June 2020, 578 older patients with acute STEMI admitted to the Department of Cardiology of Hebei General Hospital for direct PCI treatment were selected for this retrospective study. Patients were divided into an NRP group and normal-flow group according to whether NRP occurred during the operation. Clinical data and the examination indexes of the two groups were collected. Logistic regression was used to analyze the independent predictors of NRP, and the receiver operating characteristic curve was used to further analyze the ability of SII to predict NRP in older patients with STEMI. Results: Multivariate logistic analysis indicated that hypertension (OR=2.048, 95% CI:1.252–3.352, P=0.004), lymphocyte count (OR=0.571, 95% CI:0.368–0.885, P=0.012), platelet count (OR=1.009, 95% CI:1.005–1.013, P<0.001), hemoglobin (OR=1.015, 95% CI:1.003–1.028, P=0.018), multivessel disease (OR=2.237, 95% CI:1.407–3.558, P=0.001), and SII≥1814 (OR=3.799, 95% CI:2.190–6.593, P<0.001) were independent predictors of NRP after primary PCI in older patients with STEMI. Receiver operating characteristic curve analysis demonstrated that SII had a high predictive value for NRP (AUC=0.738; 95% CI:0.686–0.790), with the best cut-off value of 1814, a sensitivity of 52.85% and a specificity of 85.71%. Conclusion: For older patients with STEMI undergoing primary PCI, SII is a valid predictor of NRP.
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Wang et al. (2023) studied this question.
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