Key result
Higher post-PCI SIRI is linked to ~50% higher odds of microvascular obstruction in STEMI.
Why the study?
The associations and predictive performance of blood cell-derived inflammatory markers for microvascular obstruction after emergency PCI in STEMI patients were unclear.
Do post-PCI blood cell-derived inflammatory biomarkers predict the formation of microvascular obstruction in STEMI patients undergoing emergency revascularization?
Cohort (n=311)
No
Do post-PCI blood cell-derived inflammatory biomarkers predict the formation of microvascular obstruction in STEMI patients undergoing emergency revascularization?
Odds Ratio: 1.5 (95% CI 1.1–2.05)
p-value: p=0.0103
Routine post-PCI inflammatory indices, particularly the systemic inflammatory response index (SIRI), demonstrate exploratory predictive utility for detecting microvascular obstruction after emergency revascularization in STEMI.
Post-PCI SIRI may aid MVO risk stratification in STEMI; hypothesis-generating and requires prospective validation before adoption.
Purpose To assess the associations of blood cell-derived inflammatory markers with the formation of microvascular obstruction (MVO) and their exploratory predictive performance in STEMI patients after PCI. Patients and methods A retrospective analysis was conducted based on a prospective cohort, which included the patients with ST-segment elevation myocardial infarction (STEMI) who underwent emergency percutaneous coronary intervention (PCI) at Nanjing Drum Tower Hospital. All patients underwent cardiac magnetic resonance imaging within 7 days post-surgery, and were classified into MVO and non-MVO groups based on the examination results. Emergency and first post-PCI routine blood test and other clinical data were collected from patients, and various cell ratios were calculated, including the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI). The risk factors for MVO were evaluated by univariate and multivariate logistic regression analysis. Results A total of 311 patients with STEMI were included. Among them, 198 developed MVO and the other 113 were MVO free. After adjustment for clinical covariates, higher post-PCI WBC, NEU, SIRI and NLR and greater peri-PCI eosinophil decline were associated with MVO. In the correlation-reduced joint analysis, post-PCI SIRI retained the most robust association. Conclusion Postoperative WBC, NEU, SIRI, NLR, Δ EOS, Δ EOS% showed exploratory predictive performance for the formation of MVO after PCI in STEMI patients, and post-PCI SIRI showed the most robust association after accounting for biomarker intercorrelation.
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Dai et al. (2026) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=311). Post-PCI systemic inflammatory response index (SIRI) vs. Lower post-PCI SIRI was evaluated on Formation of microvascular obstruction (MVO) evaluated by cardiac magnetic resonance imaging within 7 days post-surgery (OR 1.50, 95% CI 1.10-2.05, p=0.0103). Higher post-PCI systemic inflammatory response index (SIRI) was independently associated with the formation of microvascular obstruction in STEMI patients after emergency revascularization (OR 1.50).
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