Association of SII and SIRI with anxiety and depression severity in patients with acute coronary syndrome: A retrospective cross-sectional study

Emerging evidence indicates that inflammatory mechanisms may play a key role in linking psychological disorders to cardiovascular outcomes. This study aimed to explore the association between anxiety and depression levels and two inflammatory markers, the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), in patients with acute coronary syndrome (ACS). This retrospective cross-sectional study was conducted on 1498 patients with ACS who underwent coronary angiography (CAG) in Rasht, Iran, between January 2022 and June 2023. SII and SIRI were calculated for all patients. Patients’ psychological status regarding anxiety and depression was evaluated using the Hospital Anxiety and Depression Scale (HADS). All data analyses were conducted using SPSS version 22. The mean age of the patients was 58.49 ± 11.14 years, with males comprising 57.5% of the sample. Male participants exhibited significantly higher levels of anxiety and depression compared to females ( P < .05). Individuals with comorbidities showed significantly lower anxiety scores ( P < .05). Anxiety levels varied significantly based on CAG findings ( P = .004). In multivariable ordinal logistic regression analyses, neither SII nor SIRI was significantly associated with depression severity (SII: OR = 1.029, 95% CI: 0.70–1.49; SIRI: OR = 1.012, 95% CI: 0.86–1.03) or anxiety severity (SII: OR = 0.906, 95% CI: 0.63–1.29; SIRI: OR = 1.005, 95% CI: 0.98–1.03). Systemic inflammation indices (SII and SIRI) did not show significant associations with anxiety or depression severity in cardiac patients, highlighting their limited utility as psychological predictors.