Association of Systemic Immune-Inflammation Index With Adverse Outcomes in Hospitalized Patients With Pre- and Symptomatic Heart Failure

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Pre-heart failure (Stage B) and symptomatic heart failure (Stage C/D) (n=4490). Intervention: High admission systemic immune-inflammation index (SII) vs. Low admission systemic immune-inflammation index (SII). Primary outcome: Cardiac events (new-onset HF hospitalization or cardiac death in Stage B; rehospitalization for worsening HF or cardiac death in Stage C/D) (HR 1.725, 95% CI 1.018–2.923, p=0.043).

Q: What does this research mean for the field?

A high systemic immune-inflammation index is independently associated with an increased risk of cardiac events in hospitalized patients with Stage B pre-heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Naoto Ohashi; Akiomi Yoshihisa; Yu Sato; Akito Okabe; Yukiko Sugawara; Tomofumi Misaka; Tetsuro Yokokawa; Takamasa Sato; Masayoshi Oikawa; Atsushi Kobayashi; Kazuhiko Nakazato; Yasuchika Takeishi

doi:10.1253/circrep.cr-26-0349

November 13, 2026Circulation ReportsOpen Access

Association of Systemic Immune-Inflammation Index With Adverse Outcomes in Hospitalized Patients With Pre- and Symptomatic Heart Failure

View Full Paper

Ask AI

Bookmark

Share

Key result

High vs. low admission SII was independently associated with increased cardiac events in hospitalized Stage B heart failure patients.

Why the study?

Does a high admission systemic immune-inflammation index (SII) predict adverse cardiac events in hospitalized patients with pre-heart failure (Stage B) and symptomatic heart failure (Stage C/D)?

Key Points

To examine the prognostic association between the admission systemic immune-inflammation index and adverse cardiac outcomes across heart failure stages, focusing on Stage B pre-heart failure.
Prospective observational study of consecutive cardiovascular inpatients enrolled between April 2010 and September 2023 at a single center, excluding patients with cancer or C-reactive protein >10 mg/dL (N=4,490; Stage B, n=2,384; Stage C/D, n=2,106).
Systemic immune-inflammation index was calculated from admission blood counts (platelet count × neutrophil count / lymphocyte count) and categorized into stage-specific tertiles.
Assessed cardiac events (new-onset heart failure hospitalization or cardiac death in Stage B; median follow-up of 1,332 days) using multivariable Cox proportional hazards models adjusting for clinical risk factors, B-type natriuretic peptide, and C-reactive protein.
In Stage B pre-heart failure, high versus low systemic immune-inflammation index was independently associated with cardiac events (HR, 1.725; 95% CI, 1.018–2.923; P=0.043).
Adding the systemic immune-inflammation index to standard risk factors modestly improved discrimination for future cardiac events.

Study Design

Type

Cohort (n=4,490)

Multicenter

No

Structured PICO

Does a high admission systemic immune-inflammation index (SII) predict adverse cardiac events in hospitalized patients with pre-heart failure (Stage B) and symptomatic heart failure (Stage C/D)?

P

Population

4,490 cardiovascular inpatients with Stage B pre-heart failure (n=2,384) or Stage C/D symptomatic heart failure (n=2,106) without cancer or CRP >10 mg/dL at a single center in Japan, with Stage B followed for a median of 1,332 days.

E

Exposure

High admission systemic immune-inflammation index (SII, calculated as platelet count × neutrophil count / lymphocyte count from admission blood counts, analyzed by stage-specific tertiles)

C

Comparator

Low admission systemic immune-inflammation index (SII) tertile

O

Outcome

Composite of cardiac events, defined as new-onset heart failure hospitalization or cardiac death in Stage B (at median follow-up of 1,332 days) and rehospitalization for worsening heart failure or cardiac death in Stage C/Dcomposite

Main Result

Hazard Ratio: 1.725 (95% CI 1.018–2.923)

p-value: p=0.043

Limitations

Single-center design
One admission SII measurement susceptible to acute illness or physiological stress
Unavailable stable/elective-only sensitivity analyses
Possible residual confounding

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Admission systemic immune-inflammation index (SII), derived from routine blood counts, provides independent and complementary prognostic information for cardiac events in hospitalized Stage B pre-heart failure patients before symptom onset.

Abstract

Background: The prognostic value of the systemic immune–inflammation index (SII) in pre-heart failure (HF) is unclear. Methods and Results: The analysis included 4,490 cardiovascular inpatients without cancer or C-reactive protein >10 mg/dL (stage B, n=2,384; stage C/D, n=2,106). In Stage B, high vs. low SII was independently associated with cardiac events (hazard ratio, 1.725; 95% confidence interval, 1.018–2.923; P=0.043). Adding SII modestly improved discrimination. Conclusions: Admission SII may provide complementary prognostic information for cardiac events in hospitalized Stage B patients before symptomatic HF develops.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Ohashi et al. (2026) conducted a cohort in Pre-heart failure (Stage B) and symptomatic heart failure (Stage C/D) (n=4,490). High admission systemic immune-inflammation index (SII) vs. Low admission systemic immune-inflammation index (SII) was evaluated on Cardiac events (new-onset HF hospitalization or cardiac death in Stage B; rehospitalization for worsening HF or cardiac death in Stage C/D) (HR 1.725, 95% CI 1.018–2.923, p=0.043). High vs. low admission SII was independently associated with increased cardiac events in hospitalized Stage B heart failure patients.

synapsesocial.com/papers/6af88ceb0e4d8f4b089c1c45 https://doi.org/10.1253/circrep.cr-26-0349

View Full Paper

Ask AI

Bookmark

Share

Association of Systemic Immune-Inflammation Index With Adverse Outcomes in Hospitalized Patients With Pre- and Symptomatic Heart Failure

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Association of Systemic Immune-Inflammation Index With Adverse Outcomes in Hospitalized Patients With Pre- and Symptomatic Heart Failure

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading