[Correlation and predictive value analysis of systemic inflammation grade and plaque stability in patients with carotid artery stenosis].

Abstract

Objective: To analyze the correlation between the systemic inflammation score (SIG) and plaque stability in patients with carotid artery stenosis, and to evaluate the predictive value. Methods: The clinical data of 149 patients with carotid artery stenosis who were hospitalized in Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2019 to October 2023 were retrospectively analyzed, including 124 males and 25 females, aged (68.2±8.9) years. According to the results of pathological analysis of specimens after carotid endarterectomy, the patients were divided into plaque stable group (n=70) and plaque vulnerable group (n=79). After preoperative blood biochemical indexes were collected and neutrophil-lymphocyte ratio and modified glasgow prognostic score(mGPS) were calculated, the SIG was calculated together. The multivariate logistic regression model was used to analyze the correlative factors of plaque stability in patients with carotid artery stenosis, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of SIG for plaque stability in patients with carotid artery stenosis. Results: The proportion of patients with a history of diabetes in the plaque vulnerable group [36.7% (29/79) vs 20.0% (14/70)] and IL-6 [0.43 (0.31, 0.64) vs 0.34 (0.17, 0.44) ng/L] were higher than those in the plaque stabilization group(both P<0.05). The mGPS score and SIG score of the plaque vulnerable group were higher than those of the plaque stabilization group (both P<0.05). The results of the multivariate logistic regression model showed that diabetes history (OR=2.82, 95%CI: 1.23-6.48), high interleukin-6 (IL-6) level (OR=1.16, 95%CI: 1.01-1.33), and high SIG scores [with SIG=0 as the reference, OR (SIG=1)=1.76,95%CI:1.21-2.41;OR (SIG=2)=2.21,95%CI:1.51-3.01;OR (SIG=3)=4.47,95%CI:2.42-6.52;OR (SIG=4)=3.19,95%CI:2.01-4.36] were risk factors for plaque instability in patients with carotid artery stenosis. The results of ROC curve analysis showed that when the SIG cut-off value was 1.5 points, the sensitivity and specificity of predicting plaque stability in patients with carotid artery stenosis were 70.0%, the specificity was 74.3%, and the area under the curve was 0.745 (95%CI: 0.666-0.825, P<0.001). Conclusion: High SIG score is a risk factor for plaque stability in patients with carotid artery stenosis and has a good predictive value.