{"title":"Systemic Immune-Inflammation Index Predicts Restenosis after Interventions for Lower Extremity Arteriosclerosis Obliterans.","authors":"Shao-Yong Tian","doi":"10.1532/hsf.5303","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To investigate the association between the pretreatment systemic immune-inflammation index (SII) and restenosis after interventions for lower extremity arteriosclerosis obliterans (ASO).</p><p><strong>Methods: </strong>We retrospectively evaluated 309 patients with ASO who underwent endovascular interventions between January 2018 and December 2021. Pretreatment inflammatory markers, including the SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and C-reactive protein (CRP) were collected. The logistic regression model was used to determine the associations between these inflammatory markers and restenosis. Clinical manifestations, ankle-brachial index (ABI), and quality of life after intervention also were compared.</p><p><strong>Results: </strong>The pretreatment SII (p < 0.001), NLR (p < 0.001), PLR (p < 0.001), SIRI (p = 0.002), AISI (p < 0.001), and CRP (p = 0.036) were significantly higher in patients with restenosis than in those without restenosis. Among the four markers, SII had the highest area under the curve (AUC) in predicting restenosis (SII vs. NLR vs. PLR vs. SIRI vs. AISI vs. CRP: 0.715 vs. 0.689 vs. 0.695 vs. 0.643 vs. 0.691 vs. 0.596). Multivariate analysis revealed that the pretreatment SII was the only independent factor for restenosis (hazard ratio [HR]: 4.102; 95% confidence interval [CI]: 1.155-14.567; p = 0.029). Moreover, a lower SII was associated with significantly better improvements in clinical manifestations (Rutherford classification 1-2: 67.5% vs. 52.9%, p = 0.038) and ABI (median: 0.29 vs. 0.22; p = 0.029), together with better quality of life (p < 0.05 for physical functioning, social functioning, pain, and mental health).</p><p><strong>Conclusions: </strong>The pretreatment SII is an independent predictor of restenosis after interventions in patients with lower extremity ASO, providing more accurate prognosis prediction than other inflammatory markers.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 3","pages":"E225-E233"},"PeriodicalIF":0.7000,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Surgery Forum","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1532/hsf.5303","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 1
Abstract
Background: To investigate the association between the pretreatment systemic immune-inflammation index (SII) and restenosis after interventions for lower extremity arteriosclerosis obliterans (ASO).
Methods: We retrospectively evaluated 309 patients with ASO who underwent endovascular interventions between January 2018 and December 2021. Pretreatment inflammatory markers, including the SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and C-reactive protein (CRP) were collected. The logistic regression model was used to determine the associations between these inflammatory markers and restenosis. Clinical manifestations, ankle-brachial index (ABI), and quality of life after intervention also were compared.
Results: The pretreatment SII (p < 0.001), NLR (p < 0.001), PLR (p < 0.001), SIRI (p = 0.002), AISI (p < 0.001), and CRP (p = 0.036) were significantly higher in patients with restenosis than in those without restenosis. Among the four markers, SII had the highest area under the curve (AUC) in predicting restenosis (SII vs. NLR vs. PLR vs. SIRI vs. AISI vs. CRP: 0.715 vs. 0.689 vs. 0.695 vs. 0.643 vs. 0.691 vs. 0.596). Multivariate analysis revealed that the pretreatment SII was the only independent factor for restenosis (hazard ratio [HR]: 4.102; 95% confidence interval [CI]: 1.155-14.567; p = 0.029). Moreover, a lower SII was associated with significantly better improvements in clinical manifestations (Rutherford classification 1-2: 67.5% vs. 52.9%, p = 0.038) and ABI (median: 0.29 vs. 0.22; p = 0.029), together with better quality of life (p < 0.05 for physical functioning, social functioning, pain, and mental health).
Conclusions: The pretreatment SII is an independent predictor of restenosis after interventions in patients with lower extremity ASO, providing more accurate prognosis prediction than other inflammatory markers.
背景:探讨预处理全身免疫炎症指数(SII)与下肢动脉硬化闭塞症(ASO)干预后再狭窄的关系。方法:我们回顾性评估了2018年1月至2021年12月期间接受血管内介入治疗的309例ASO患者。收集预处理炎症标志物,包括SII、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身炎症反应指数(SIRI)、全身炎症聚集指数(AISI)、c反应蛋白(CRP)。logistic回归模型用于确定这些炎症标志物与再狭窄之间的关系。比较干预后两组患者的临床表现、踝肱指数(踝肱指数)及生活质量。结果:再狭窄患者预处理SII (p < 0.001)、NLR (p < 0.001)、PLR (p < 0.001)、SIRI (p = 0.002)、AISI (p < 0.001)、CRP (p = 0.036)均显著高于无再狭窄患者。在四种标志物中,SII预测再狭窄的曲线下面积(AUC)最高(SII vs NLR vs PLR vs SIRI vs AISI vs CRP: 0.715 vs 0.689 vs 0.695 vs 0.643 vs 0.691 vs 0.596)。多因素分析显示,预处理SII是再狭窄的唯一独立因素(危险比[HR]: 4.102;95%置信区间[CI]: 1.155-14.567;P = 0.029)。此外,较低的SII与临床表现(Rutherford分类1-2:67.5% vs. 52.9%, p = 0.038)和ABI(中位数:0.29 vs. 0.22;P = 0.029),以及更好的生活质量(身体功能、社会功能、疼痛和心理健康方面P < 0.05)。结论:预处理SII是下肢ASO患者干预后再狭窄的独立预测指标,比其他炎症指标更准确的预测预后。
期刊介绍:
The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.