Key result
Pre-procedural SIRI independently predicts PBMV success with ~80% specificity.
Why the study?
Inflammatory markers are associated with disease severity and outcomes in rheumatic mitral stenosis, but the predictive value of newer indices like SII and SIRI for PBMV success is unclear.
Do novel inflammatory markers like SIRI and SII predict procedural success and clinical outcomes in patients undergoing PBMV for severe rheumatic mitral stenosis?
Cohort (n=131)
No
Do novel inflammatory markers like SIRI and SII predict procedural success and clinical outcomes in patients undergoing PBMV for severe rheumatic mitral stenosis?
The systemic inflammation response index (SIRI) is a useful pre-procedural predictor of procedural success and mid-term outcomes in patients undergoing percutaneous balloon mitral valvuloplasty for severe rheumatic mitral stenosis.
May inform post-PBMV risk stratification in rheumatic mitral stenosis; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Inflammatory markers are associated with the severity of disease and outcomes in rheumatic mitral stenosis (RMS). This study explored the connection between newer inflammatory indices - specifically, the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) - and clinical outcomes in RMS patients who underwent percutaneous balloon mitral valvuloplasty (PBMV). METHODS: A total of 131 patients with severe RMS who received PBMV at Tehran Heart Center between August 2015 and February 2021 were assessed. Inflammatory markers were measured prior to the procedure. Echocardiographic parameters, Wilkins scores, and complications were analyzed over a three-year follow-up period. ROC curves and multivariate logistic regression were employed to evaluate predictive associations. RESULTS: The average age of participants was 47.9 years, and 79.4% were female. Lower systolic pulmonary pressure and younger age were associated with a greater success rate of PBMV. Frequent complications included mitral regurgitation (47.5%) and readmission (27.5%). Higher levels of NLR, MLR, SII, and SIRI were correlated with increased Wilkins scores. SIRI was an independent predictor of PBMV success. CONCLUSION: SIRI demonstrated the highest predictive capability for PBMV success, with 71% sensitivity and 80% specificity. It was also associated with complications and mid-term outcomes in severe RMS.
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Sahebjam et al. (2025) conducted a cohort in Severe rheumatic mitral stenosis (RMS) (n=131). Systemic inflammation response index (SIRI) and systemic immune inflammation index (SII) was evaluated on PBMV success. The systemic inflammation response index (SIRI) was an independent predictor of percutaneous balloon mitral valvuloplasty success, demonstrating 71% sensitivity and 80% specificity.
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