Key result
Higher baseline SIRI is linked to ~24% higher odds of post-ablation AF recurrence per SD.
Why the study?
Systemic inflammation contributes to atrial remodeling and may influence AF recurrence after catheter ablation, prompting an evaluation of the association between the baseline systemic inflammation response index (SIRI) and post-ablation AF recurrence.
Is a higher baseline systemic inflammation response index (SIRI) independently associated with atrial fibrillation recurrence within 12 months after first-time catheter ablation in adults with paroxysmal or persistent AF?
Cohort (n=504)
No
Is a higher baseline systemic inflammation response index (SIRI) independently associated with atrial fibrillation recurrence within 12 months after first-time catheter ablation in adults with paroxysmal or persistent AF?
Baseline SIRI is independently associated with post-ablation AF recurrence, and combining it with CRP significantly improves risk discrimination beyond clinical and echocardiographic factors.
Answers are grounded in this paper and cite their sources.
Baseline SIRI may refine post-ablation AF recurrence risk stratification; hypothesis-generating and requires prospective validation before clinical adoption.
Background Systemic inflammation contributes to atrial remodeling and may influence atrial fibrillation (AF) recurrence after catheter ablation. The systemic inflammation response index (SIRI), calculated as neutrophil count × monocyte count / lymphocyte count, integrates inflammatory activity and immune status. We investigated the association between baseline SIRI and AF recurrence after catheter ablation. Methods This retrospective cohort included 504 adults with paroxysmal or persistent AF who underwent catheter ablation between July 2023 and December 2024. The primary outcome was atrial tachyarrhythmia recurrence lasting at least 30 seconds after a 3-month blanking period during 12-month follow-up. Multivariable logistic regression, restricted cubic spline analysis, receiver operating characteristic analysis, DeLong testing, integrated discrimination improvement (IDI), and category-free net reclassification improvement (NRI) were performed. Results AF recurrence occurred in 140 patients (27.8%). Each 1-standard deviation increase in SIRI was associated with recurrence in univariable analysis (odds ratio [OR], 1.35; 95% confidence interval [CI], 1.10–1.65; P = 0.003) and remained independently associated after adjustment for relevant variables (adjusted OR, 1.24; 95% CI, 1.00–1.54; P = 0.045). Restricted cubic spline analysis suggested a nonlinear association. Adding SIRI to the base clinical model increased the area under the curve from 0.704 to 0.713 without a significant DeLong difference, although IDI and NRI improved. Adding SIRI and C-reactive protein increased the area under the curve to 0.732 and significantly improved DeLong, IDI, and NRI results. Conclusions Higher baseline SIRI was independently associated with AF recurrence after catheter ablation. Its incremental value alone was modest, whereas combining SIRI with C-reactive protein provided greater improvement.
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Farooq et al. (2026) conducted a cohort in Paroxysmal or persistent atrial fibrillation undergoing first-time catheter ablation (n=504). Systemic inflammation response index (SIRI) per 1-SD increase vs. Lower baseline SIRI (continuous per 1-SD) was evaluated on First documented recurrence of atrial tachyarrhythmia (AF, atrial flutter, or atrial tachycardia) lasting ≥30 seconds after a 3-month blanking period during 12-month follow-up (Adjusted OR 1.24, 95% CI 1.00-1.54, p=0.045). Each 1-SD increase in baseline SIRI was independently associated with a 24% higher odds of atrial fibrillation recurrence after catheter ablation (adjusted OR 1.24, 95% CI 1.00-1.54, P=0.045).
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