初级 PCI 后 STEMI 患者的全身免疫炎症指数 (SII) 与新发院内心衰之间的关系

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-24 eCollection Date: 2024-10-01 DOI:10.31083/j.rcm2510382
Huibo Wang, Ying Yang, Ping Zeng, Rihong Huang, Xinyong Cai, Liang Shao, Fuyuan Liu, Yuhua Lei, Dongsheng Li, Zhixing Fan, Jun Yang, Jing Zhang, Jian Yang
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引用次数: 0

摘要

背景:全身免疫炎症指数(SII)是动脉粥样硬化过程中已被证实的可靠炎症标志物。此外,炎症也是心肌梗死(MI)后心力衰竭(HF)的最重要机制之一。然而,目前尚不清楚 SII 是否与心肌梗死患者的院内心力衰竭风险有关。因此,我们旨在探讨 ST 段抬高型心肌梗死(STEMI)患者接受经皮冠状动脉介入治疗(pPCI)后,SII 与新发院内高血压风险之间的关系:2015年1月至2021年8月期间,共有5586名STEMI患者在中国的7个临床基地接受了经皮冠状动脉介入治疗。根据 SII 值将患者分为两组。采用逻辑回归分析评估了SII与STEMI患者新发院内HF之间的关系:最终纳入了 3808 名接受 pPCI 治疗的 Killip 分级 I 的 STEMI 患者。根据计算的 SII(Q1 SII:9/L,Q2 SII:≥1707.31 (×109/L))将所有纳入患者分为两组。)在对年龄、性别、生命体征、吸烟、高血压、糖尿病等因素进行未调整和多变量调整后,在校准模型 1 至 5 中,Q2 的院内 HF 风险几率比(OR)是 Q1 的 1.378-1.427 倍。亚组分析显示,Q2的OR值在男性中是Q1的1.505倍,在老年人(≥60岁)中是Q1的1.525倍。敏感性分析表明,在排除既往经历过心房颤动、心肌梗死或接受过PCI的患者后,SII升高仍与院内心房颤动风险的显著增加有关:结论:在接受 pPCI 治疗的 STEMI 患者中,SII 升高与院内 HF 风险增加有关,尤其是男性和老年患者:中国 STEMI pPCI 注册中心已在 ClinicalTrials.gov 注册(NCT04996901,https://www.clinicaltrials.gov/study/NCT04996901?cond=NCT04996901&rank=1)。
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Association between Systemic Immune-Inflammation Index (SII) and New-Onset In-Hospital Heart Failure in Patients with STEMI after Primary PCI.

Background: The systemic immune-inflammation index (SII) is a proven, reliable inflammatory marker of the atherosclerotic process. Additionally, inflammation is one of the most important mechanisms of heart failure (HF) after myocardial infarction (MI). However, it is not clear whether SII is related to the risk of in-hospital HF in patients with MI. Thus, we aimed to explore the relationship between SII and the risk of new-onset in-hospital HF in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI).

Methods: A total of 5586 patients with STEMI underwent pPCI at seven clinical sites in China from January 2015 to August 2021. The patients were divided into two groups based on the SII values. The association between SII and new-onset in-hospital HF in STEMI patients was assessed using logistic regression analysis.

Results: Ultimately, 3808 STEMI patients with Killip class I who were treated with pPCI were included. All included patients were divided into two groups based on the calculated SII (Q1 SII: <1707.31 (×109/L), Q2 SII: ≥1707.31 (×109/L)). After unadjusted and multivariate adjustment for age, gender, vital signs, smoking, hypertension, diabetes mellitus, etc., the odds ratio (OR) of the in-hospital HF risk in Q2 was 1.378-1.427 times the Q1 in the calibration Models 1 to 5. Subgroup analysis showed that the OR of Q2 was 1.505-fold higher of Q1 in males and 1.525-fold in older people (≥60 years). Sensitivity analysis showed that after excluding patients who had previously experienced HF, MI, or underwent PCI, elevated SII was still associated with a significant increase in the risk of in-hospital HF.

Conclusions: Elevated SII is associated with an increased risk of in-hospital HF in STEMI patients treated with pPCI, particularly in male and older patients.

Clinical trial registration: The Chinese STEMI pPCI Registry was registered with ClinicalTrials.gov (NCT04996901, https://www.clinicaltrials.gov/study/NCT04996901?cond=NCT04996901&rank=1).

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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