Prognostic implications of systemic immune-inflammation index in myocardial infarction patients with and without diabetes: insights from the NOAFCAMI-SH registry.
Diabetes
Generalized additive model
Myocardial infarction
Restricted cubic spline
Systemic immune-inflammation index
Journal
Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637
Informations de publication
Date de publication:
22 Jan 2024
22 Jan 2024
Historique:
received:
20
08
2023
accepted:
08
01
2024
medline:
23
1
2024
pubmed:
23
1
2024
entrez:
23
1
2024
Statut:
epublish
Résumé
It is well-known that systemic inflammation plays a crucial role in the pathogenesis and prognosis of acute myocardial infarction (AMI). The systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio) is a novel index that is used for the characterization of the severity of systemic inflammation. Recent studies have identified the high SII level as an independent predictor of poor outcomes in patients with AMI. We aimed to investigate the prognostic implications of SII in AMI patients with and without diabetes mellitus (DM). We included 2111 patients with AMI from February 2014 to March 2018. Multivariable Cox regression analyses were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause death and cardiovascular (CV) death. Multiple imputation was used for missing covariates. Of 2111 patients (mean age: 65.2 ± 12.2 years, 77.5% were males) analyzed, 789 (37.4%) had DM. Generalized additive model analyses showed that as the SII increased, the C-reactive protein and peak TnT elevated while the LVEF declined, and these associations were similar in patients with and without DM. During a median of 2.5 years of follow-up, 210 all-cause deaths and 154 CV deaths occurred. When treating the SII as a continuous variable, a higher log-transformed SII was significantly associated with increased all-cause mortality (HR: 1.57, 95%CI: 1.02-2.43) and CV mortality (HR: 1.85, 95%CI 1.12-3.05), and such an association was also significant in the diabetics (HRs and 95%CIs for all-cause death and CV death were 2.90 [1.40-6.01] and 3.28 [1.43-7.57], respectively) while not significant in the nondiabetics (P In AMI patients with DM, high SII is an independent predictor of poor survival and may be helpful for patient's risk stratification.
Sections du résumé
BACKGROUND
BACKGROUND
It is well-known that systemic inflammation plays a crucial role in the pathogenesis and prognosis of acute myocardial infarction (AMI). The systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio) is a novel index that is used for the characterization of the severity of systemic inflammation. Recent studies have identified the high SII level as an independent predictor of poor outcomes in patients with AMI. We aimed to investigate the prognostic implications of SII in AMI patients with and without diabetes mellitus (DM).
METHODS
METHODS
We included 2111 patients with AMI from February 2014 to March 2018. Multivariable Cox regression analyses were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause death and cardiovascular (CV) death. Multiple imputation was used for missing covariates.
RESULTS
RESULTS
Of 2111 patients (mean age: 65.2 ± 12.2 years, 77.5% were males) analyzed, 789 (37.4%) had DM. Generalized additive model analyses showed that as the SII increased, the C-reactive protein and peak TnT elevated while the LVEF declined, and these associations were similar in patients with and without DM. During a median of 2.5 years of follow-up, 210 all-cause deaths and 154 CV deaths occurred. When treating the SII as a continuous variable, a higher log-transformed SII was significantly associated with increased all-cause mortality (HR: 1.57, 95%CI: 1.02-2.43) and CV mortality (HR: 1.85, 95%CI 1.12-3.05), and such an association was also significant in the diabetics (HRs and 95%CIs for all-cause death and CV death were 2.90 [1.40-6.01] and 3.28 [1.43-7.57], respectively) while not significant in the nondiabetics (P
CONCLUSIONS
CONCLUSIONS
In AMI patients with DM, high SII is an independent predictor of poor survival and may be helpful for patient's risk stratification.
Identifiants
pubmed: 38254086
doi: 10.1186/s12933-024-02129-x
pii: 10.1186/s12933-024-02129-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
41Subventions
Organisme : National Natural Science Foundation of China
ID : 82200318
Organisme : Climbing Program of Shanghai Tenth People's Hospital
ID : 2021SYPDRC049Au1
Organisme : Climbing Program of Shanghai Tenth People's Hospital
ID : 2021SYPDRC035
Organisme : Natural Science Foundation of Shanghai
ID : 18ZR1429700
Informations de copyright
© 2024. The Author(s).
Références
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746–53.
doi: 10.1161/hc4601.099487
pubmed: 11723030
Prabhu SD, Frangogiannis NG. The biological basis for cardiac repair after myocardial infarction: from inflammation to fibrosis. Circ Res. 2016;119(1):91–112.
doi: 10.1161/CIRCRESAHA.116.303577
pubmed: 27340270
pmcid: 4922528
Murphy AJ, Tall AR. Disordered haematopoiesis and athero-thrombosis. Eur Heart J. 2016;37(14):1113–21.
doi: 10.1093/eurheartj/ehv718
pubmed: 26869607
pmcid: 4823636
Shetelig C, Limalanathan S, Hoffmann P, et al. Association of IL-8 with infarct size and clinical outcomes in patients with STEMI. J Am Coll Cardiol. 2018;72(2):187–98.
doi: 10.1016/j.jacc.2018.04.053
pubmed: 29976293
Henein MY, Vancheri S, Longo G, Vancheri F. The role of inflammation in cardiovascular disease. Int J Mol Sci. 2022;23(21):12906.
doi: 10.3390/ijms232112906
pubmed: 36361701
pmcid: 9658900
Shahrivari M, Wise E, Resende M, et al. Peripheral blood cytokine levels after acute myocardial infarction: IL-1β- and IL-6-related impairment of bone marrow function. Circ Res. 2017;120(12):1947–57.
doi: 10.1161/CIRCRESAHA.116.309947
pubmed: 28490433
pmcid: 5508725
Huang S, Frangogiannis NG. Anti-inflammatory therapies in myocardial infarction: failures, hopes and challenges. Br J Pharmacol. 2018;175(9):1377–400.
doi: 10.1111/bph.14155
pubmed: 29394499
pmcid: 5901181
Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med. 2019;381(26):2497–505.
doi: 10.1056/NEJMoa1912388
pubmed: 31733140
Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377(12):1119–31.
doi: 10.1056/NEJMoa1707914
pubmed: 28845751
Morton AC, Rothman AM, Greenwood JP, et al. The effect of interleukin-1 receptor antagonist therapy on markers of inflammation in non-ST elevation acute coronary syndromes: the MRC-ILA Heart Study. Eur Heart J. 2015;36(6):377–84.
doi: 10.1093/eurheartj/ehu272
pubmed: 25079365
Hudson MP, Armstrong PW, Ruzyllo W, et al. Effects of selective matrix metalloproteinase inhibitor (PG-116800) to prevent ventricular remodeling after myocardial infarction: results of the PREMIER (Prevention of Myocardial Infarction Early Remodeling) trial. J Am Coll Cardiol. 2006;48(1):15–20.
doi: 10.1016/j.jacc.2006.02.055
pubmed: 16814643
Ridker PM. From C-reactive protein to interleukin-6 to interleukin-1: moving upstream to identify novel targets for atheroprotection. Circ Res. 2016;118(1):145–56.
doi: 10.1161/CIRCRESAHA.115.306656
pubmed: 26837745
pmcid: 4793711
Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212–22.
doi: 10.1158/1078-0432.CCR-14-0442
pubmed: 25271081
Wang Z, Qin Z, Yuan R, et al. Systemic immune-inflammation index as a prognostic marker for advanced chronic heart failure with renal dysfunction. ESC Heart Fail. 2023;10(1):478–91.
doi: 10.1002/ehf2.14217
pubmed: 36316302
Xu M, Chen R, Liu L, et al. Systemic immune-inflammation index and incident cardiovascular diseases among middle-aged and elderly Chinese adults: The Dongfeng-Tongji cohort study. Atherosclerosis. 2021;323:20–9.
doi: 10.1016/j.atherosclerosis.2021.02.012
pubmed: 33773161
Pradhan AD, Ridker PM. Do atherosclerosis and type 2 diabetes share a common inflammatory basis? Eur Heart J. 2002;23(11):831–4.
doi: 10.1053/euhj.2001.3052
pubmed: 12042000
Malmberg K, Yusuf S, Gerstein HC, et al. Impact of diabetes on long-term prognosis in patients with unstable angina and non-Q-wave myocardial infarction: results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) Registry. Circulation. 2000;102(9):1014–9.
doi: 10.1161/01.CIR.102.9.1014
pubmed: 10961966
Fei Q, Ma H, Zou J, et al. Metformin protects against ischaemic myocardial injury by alleviating autophagy-ROS-NLRP3-mediated inflammatory response in macrophages. J Mol Cell Cardiol. 2020;145:1–13.
doi: 10.1016/j.yjmcc.2020.05.016
pubmed: 32470468
Paolisso P, Bergamaschi L, Santulli G, et al. Infarct size, inflammatory burden, and admission hyperglycemia in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: a multicenter international registry. Cardiovasc Diabetol. 2022;21(1):77.
doi: 10.1186/s12933-022-01506-8
pubmed: 35570280
pmcid: 9107763
Luo J, Xu S, Li H, et al. Long-term impact of the burden of new-onset atrial fibrillation in patients with acute myocardial infarction: results from the NOAFCAMI-SH registry. Europace. 2021;23(2):196–204.
doi: 10.1093/europace/euaa234
pubmed: 32929491
Luo J, Xu S, Li H, et al. Long-term impact of new-onset atrial fibrillation complicating acute myocardial infarction on heart failure. ESC Heart Fail. 2020;7(5):2762–72.
doi: 10.1002/ehf2.12872
pubmed: 32578394
pmcid: 7524129
Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231–64.
doi: 10.1016/j.jacc.2018.08.1038
pubmed: 30153967
Rubin D. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.
doi: 10.1002/9780470316696
Fullerton JN, Gilroy DW. Resolution of inflammation: a new therapeutic frontier. Nat Rev Drug Discov. 2016;15(8):551–67.
doi: 10.1038/nrd.2016.39
pubmed: 27020098
Rurik JG, Aghajanian H, Epstein JA. Immune cells and immunotherapy for cardiac injury and repair. Circ Res. 2021;128(11):1766–79.
doi: 10.1161/CIRCRESAHA.121.318005
pubmed: 34043424
pmcid: 8171813
Aksakal E, Aksu U, Birdal O, et al. Role of systemic immune-inflammatory index in predicting the development of in-hospital malignant ventricular arrhythmia in patients with ST-elevated myocardial infarction. Angiology. 2022;74:881.
doi: 10.1177/00033197221121435
pubmed: 35977560
Dolu AK, Karayiğit O, Ozkan C, Çelik MC, Kalçık M. Relationship between intracoronary thrombus burden and systemic immune-inflammation index in patients with ST-segment elevation myocardial infarction. Acta Cardiol. 2023;78(1):72–9.
doi: 10.1080/00015385.2022.2035082
pubmed: 35105281
Orhan AL, Şaylık F, Çiçek V, et al. Evaluating the systemic immune-inflammation index for in-hospital and long-term mortality in elderly non-ST-elevation myocardial infarction patients. Aging Clin Exp Res. 2022;34(7):1687–95.
doi: 10.1007/s40520-022-02103-1
pubmed: 35275375
Zhang N, Aiyasiding X, Li WJ, Liao HH, Tang QZ. Neutrophil degranulation and myocardial infarction. Cell Commun Signal. 2022;20(1):50.
doi: 10.1186/s12964-022-00824-4
pubmed: 35410418
pmcid: 8996539
Totani L, Evangelista V. Platelet-leukocyte interactions in cardiovascular disease and beyond. Arterioscler Thromb Vasc Biol. 2010;30(12):2357–61.
doi: 10.1161/ATVBAHA.110.207480
pubmed: 21071701
pmcid: 3076621
Li Q, Ma X, Shao Q, et al. Prognostic impact of multiple lymphocyte-based inflammatory indices in acute coronary syndrome patients. Front Cardiovasc Med. 2022;9:811790.
doi: 10.3389/fcvm.2022.811790
pubmed: 35592392
pmcid: 9110784
Biccirè FG, Farcomeni A, Gaudio C, et al. D-dimer for risk stratification and antithrombotic treatment management in acute coronary syndrome patients: a systematic review and metanalysis. Thromb J. 2021;19(1):102.
doi: 10.1186/s12959-021-00354-y
pubmed: 34922573
pmcid: 8684263
Marfella R, Di Filippo C, Portoghese M, et al. Tight glycemic control reduces heart inflammation and remodeling during acute myocardial infarction in hyperglycemic patients. J Am Coll Cardiol. 2009;53(16):1425–36.
doi: 10.1016/j.jacc.2009.01.041
pubmed: 19371826
Karima M, Kantarci A, Ohira T, et al. Enhanced superoxide release and elevated protein kinase C activity in neutrophils from diabetic patients: association with periodontitis. J Leukoc Biol. 2005;78(4):862–70.
doi: 10.1189/jlb.1004583
pubmed: 16081595
Wong SL, Demers M, Martinod K, et al. Diabetes primes neutrophils to undergo NETosis, which impairs wound healing. Nat Med. 2015;21(7):815–9.
doi: 10.1038/nm.3887
pubmed: 26076037
pmcid: 4631120
Menegazzo L, Ciciliot S, Poncina N, et al. NETosis is induced by high glucose and associated with type 2 diabetes. Acta Diabetol. 2015;52(3):497–503.
doi: 10.1007/s00592-014-0676-x
pubmed: 25387570
Njeim R, Azar WS, Fares AH, et al. NETosis contributes to the pathogenesis of diabetes and its complications. J Mol Endocrinol. 2020;65(4):R65-r76.
doi: 10.1530/JME-20-0128
pubmed: 33048064
Josefs T, Barrett TJ, Brown EJ, et al. Neutrophil extracellular traps promote macrophage inflammation and impair atherosclerosis resolution in diabetic mice. JCI Insight. 2020;5(7).
de Lemos JA, Morrow DA, Sabatine MS, et al. Association between plasma levels of monocyte chemoattractant protein-1 and long-term clinical outcomes in patients with acute coronary syndromes. Circulation. 2003;107(5):690–5.
doi: 10.1161/01.CIR.0000049742.68848.99
pubmed: 12578870
Gabriel AS, Martinsson A, Wretlind B, Ahnve S. IL-6 levels in acute and post-myocardial infarction: their relation to CRP levels, infarction size, left ventricular systolic function, and heart failure. Eur J Intern Med. 2004;15(8):523–8.
doi: 10.1016/j.ejim.2004.07.013
pubmed: 15668089