Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study

Abstract Background A higher risk of cardiovascular disease has been correlated with several inflammatory biomarkers, one of which is the systemic immune-inflammatory index (SII). Nevertheless, the relationship between SII and major adverse cardiovascular and cerebrovascular events (MACCE) in patien...

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Main Authors: Leli Zhang, Shen Wang, Yue Wang, Pengrong Guo, Shou Pang, Boqun Shi, Xiaofan Wu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04990-4
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author Leli Zhang
Shen Wang
Yue Wang
Pengrong Guo
Shou Pang
Boqun Shi
Xiaofan Wu
author_facet Leli Zhang
Shen Wang
Yue Wang
Pengrong Guo
Shou Pang
Boqun Shi
Xiaofan Wu
author_sort Leli Zhang
collection DOAJ
description Abstract Background A higher risk of cardiovascular disease has been correlated with several inflammatory biomarkers, one of which is the systemic immune-inflammatory index (SII). Nevertheless, the relationship between SII and major adverse cardiovascular and cerebrovascular events (MACCE) in patients with diabetes and acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) remains unclear. The objective of this study was to assess the prognostic value of SII for the risk of MACCE in patients with diabetes and ACS who underwent PCI. Methods This study included 1782 patients with ACS and diabetes who underwent PCI successfully at Beijing Anzhen Hospital between August 2021 and April 2022, with a median follow-up of 16.2 months. According to the optimal SII cut-off value for MACCE, patients were categorized into two groups: the high SII group (SII ≥ 735.82 × 109/L, n = 576) and the low SII group (SII < 735.82 × 109/L, n = 1206). Univariate and multivariate Cox regression were used to verify the relationship between SII and MACCE, and the reliability of the relationship was further tested by subgroup analysis. Results The incidence of MACCE was significantly higher in the high SII group than in the low SII group (11.3% vs. 6.7%, log-rank P < 0.001), indicating that among 22 patients with high SII levels, an additional MACCE event is expected to occur. Univariate Cox proportional hazards models showed that higher SII was associated with an increased incidence of MACCE (HR: 1.739, 95%CI: 1.254–2.410). After full adjustment, higher SII remained an independent risk factor for MACCE (HR: 1.540, 95%CI: 1.098–2.160) and unplanned revascularization (HR: 1.526, 95%CI: 1.011–2.301). Conclusion This study found that elevated SII is an independent risk factor for predicting MACCE in patients with ACS and diabetes mellitus after PCI, providing a theoretical basis for postoperative anti-inflammatory therapy in this population.
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spelling doaj-art-fa9554bca5d947a58932d2f3522cf3372025-08-24T11:06:51ZengBMCBMC Cardiovascular Disorders1471-22612025-08-0125111310.1186/s12872-025-04990-4Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort studyLeli Zhang0Shen Wang1Yue Wang2Pengrong Guo3Shou Pang4Boqun Shi5Xiaofan Wu6Department of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical UniversityAbstract Background A higher risk of cardiovascular disease has been correlated with several inflammatory biomarkers, one of which is the systemic immune-inflammatory index (SII). Nevertheless, the relationship between SII and major adverse cardiovascular and cerebrovascular events (MACCE) in patients with diabetes and acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) remains unclear. The objective of this study was to assess the prognostic value of SII for the risk of MACCE in patients with diabetes and ACS who underwent PCI. Methods This study included 1782 patients with ACS and diabetes who underwent PCI successfully at Beijing Anzhen Hospital between August 2021 and April 2022, with a median follow-up of 16.2 months. According to the optimal SII cut-off value for MACCE, patients were categorized into two groups: the high SII group (SII ≥ 735.82 × 109/L, n = 576) and the low SII group (SII < 735.82 × 109/L, n = 1206). Univariate and multivariate Cox regression were used to verify the relationship between SII and MACCE, and the reliability of the relationship was further tested by subgroup analysis. Results The incidence of MACCE was significantly higher in the high SII group than in the low SII group (11.3% vs. 6.7%, log-rank P < 0.001), indicating that among 22 patients with high SII levels, an additional MACCE event is expected to occur. Univariate Cox proportional hazards models showed that higher SII was associated with an increased incidence of MACCE (HR: 1.739, 95%CI: 1.254–2.410). After full adjustment, higher SII remained an independent risk factor for MACCE (HR: 1.540, 95%CI: 1.098–2.160) and unplanned revascularization (HR: 1.526, 95%CI: 1.011–2.301). Conclusion This study found that elevated SII is an independent risk factor for predicting MACCE in patients with ACS and diabetes mellitus after PCI, providing a theoretical basis for postoperative anti-inflammatory therapy in this population.https://doi.org/10.1186/s12872-025-04990-4Systemic immune-inflammation indexDiabetesAcute coronary syndromePercutaneous coronary intervention
spellingShingle Leli Zhang
Shen Wang
Yue Wang
Pengrong Guo
Shou Pang
Boqun Shi
Xiaofan Wu
Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study
BMC Cardiovascular Disorders
Systemic immune-inflammation index
Diabetes
Acute coronary syndrome
Percutaneous coronary intervention
title Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study
title_full Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study
title_fullStr Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study
title_full_unstemmed Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study
title_short Prognostic value of systemic immune-Inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention: a prospective cohort study
title_sort prognostic value of systemic immune inflammatory index in patients with diabetes mellitus and acute coronary syndrome after percutaneous coronary intervention a prospective cohort study
topic Systemic immune-inflammation index
Diabetes
Acute coronary syndrome
Percutaneous coronary intervention
url https://doi.org/10.1186/s12872-025-04990-4
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