Key result
Higher systemic immune-inflammation index predicts no-reflow after primary PCI with ~82% accuracy outside gray zone.
Why the study?
The uncertainty of systemic immune-inflammation index (SII) for diagnosing no-reflow phenomenon after primary PCI in STEMI patients was not well characterized.
How do the 'grey zone' and 'uncertain interval' approaches compare in defining the uncertainty of the Systemic immune-inflammation index (SII) for predicting no-reflow in STEMI patients undergoing primary PCI?
Cross-Sectional (n=510)
No
How do the 'grey zone' and 'uncertain interval' approaches compare in defining the uncertainty of the Systemic immune-inflammation index (SII) for predicting no-reflow in STEMI patients undergoing primary PCI?
The study defines the uncertain diagnostic ranges of the Systemic immune-inflammation index for predicting no-reflow in STEMI patients, highlighting differences between statistical approaches.
Answers are grounded in this paper and cite their sources.
SII may aid no-reflow risk stratification in STEMI primary PCI; leaves open prospective validation before clinical adoption.
Systemic immune-inflammation index (SII), which is a good predictive marker for coronary artery disease, can be calculated by using platelet, neutrophil, and lymphocyte counts. The no-reflow occurrence can also be predicted using the SII. The aim of this study is to reveal the uncertainty of SII for diagnosing ST-elevation myocardial infarction (STEMI) patients who were admitted for primary percutaneous coronary intervention (PCI) for the no-reflow phenomenon. A total of 510 consecutive acute (STEMI) patients with primary PCI were reviewed and included retrospectively. For diagnostic tests which are not a gold standard, there is always an overlap between the results of patients with and without a certain disease. In the literature, for quantitative diagnostic tests where the diagnosis is not certain, two approaches have been proposed, named "grey zone" and "uncertain interval". The uncertain area of the SII, which is given the general term "gray zone" in this article, was constructed and its results were compared with the "grey zone" and "uncertain interval" approaches. The lower and upper limits of the gray zone were found to be 611.504-1790.827 and 1186.576-1565.088 for the grey zone and uncertain interval approaches, respectively. A higher number of patients inside the gray zone and higher performance outside the gray zone were found for the grey zone approach. One should be aware of the differences between the two approaches when making a decision. The patients who were in this gray zone should be observed carefully for detection of the no-reflow phenomenon.
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Öztürk et al. (2023) conducted a cross-sectional in ST-elevation myocardial infarction (STEMI) with no-reflow phenomenon (n=510). Systemic Immune-Inflammation Index (SII) vs. Normal flow was evaluated on Accuracy of SII for predicting no-reflow outside the gray zone (grey zone approach) (Accuracy 0.824, 95% CI 0.776-0.864). The systemic immune-inflammation index demonstrated high diagnostic performance for predicting no-reflow after primary PCI, with an accuracy of 82.4% outside the calculated gray zone of 611.5 to 1790.8.
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