The relationship between systemic immune inflammatory index and prognosis of coronary heart disease: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Jie ¹ , LONG Linzi ¹ , QU Hua ^1,2 , TAN Ling ¹ , LI Hongzheng ^1,3 , YANG Wenwen ¹ ,  FU Changgeng ^1,2

1. Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 10091, P. R. China;
2. National Clinical Medical Research Center for Traditional Chinese Medicine Cardiovascular Disease, Beijing 10091, P. R. China;
3. Graduate School of Beijing University of Chinese Medicine, Beijing 100105, P. R. China;

Corresponding?author：

FU Changgeng, Email: fucgbs@163.com

Keywords：

Coronary heart disease; Systemic immune inflammation index; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.202303089

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the relationship between systemic immune inflammatory index (SII) and the prognosis of coronary heart disease. Methods The CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, Ovid, Cochrane Library and Scopus databases were electronically searched to collect cohort studies related to the relationship between SII and the prognosis of patients with coronary heart disease from inception to December 10, 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 15.0 software. Results A total of 7 cohort studies involving 18 413 patients were included. The results of meta-analysis showed that the group of high level SII was higher risk of major adverse cardiovascular events (MACE) (OR=2.2, 95%Cl 1.5 to 3.3, P<0.01), all-cause death (OR=2.0, 95%Cl 1.1 to 3.4, P=0.02), and cardiogenic death (OR=2.4, 95%Cl 1.5 to 3.9, P<0.01) than the group of low level SII. However, no significant difference was found in the risk of re-hospitalization for heart failure. Conclusion The current evidence shows that high levels of SII can increase the risk of MACE, all-cause death and cardiogenic death in patients with coronary heart disease. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： WANG Jie, LONG Linzi, QU Hua, TAN Ling, LI Hongzheng, YANG Wenwen, FU Changgeng. The relationship between systemic immune inflammatory index and prognosis of coronary heart disease: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(10): 1143-1147. doi: 10.7507/1672-2531.202303089 Copy

1.	Henein MY, Vancheri S, Longo G, et al. The role of inflammation in cardiovascular disease. Int J Mol Sci, 2022, 23(21): 12906.
2.	González L, Bulnes JF, Orellana MP, et al. The role of colchicine in atherosclerosis: from bench to bedside. Pharmaceutics, 2022, 14(7): 1395.
3.	Shaya GE, Leucker TM, Jones SR, et al. Coronary heart disease risk: low-density lipoprotein and beyond. Trends Cardiovasc Med, 2022, 32(4): 181-194.
4.	Wang P, Guo X, Zhou Y, et al. Monocyte-to-high-density lipoprotein ratio and systemic inflammation response index are associated with the risk of metabolic disorders and cardiovascular diseases in general rural population. Front Endocrinol (Lausanne), 2022, 13: 944991.
5.	Hu Q, Hisamatsu T, Haemmerle M, et al. Role of platelet-derived Tgfβ1 in the progression of ovarian cancer. Clin Cancer Res, 2017, 23(18): 5611-5621.
6.	Dziedzic EA, G?sior JS, Tuzimek A, et al. Investigation of the associations of novel inflammatory biomarkers-systemic inflammatory index (SII) and systemic inflammatory response index (SIRI)-with the severity of coronary artery disease and acute coronary syndrome occurrence. Int J Mol Sci, 2022, 23(17): 9553.
7.	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, 33197221121435.
8.	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.
9.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10.	蔣愛民, 任夢迪, 馬宇彥, 等. 預后營養指數作為非小細胞肺癌預后因素的Meta分析. 現代腫瘤醫學, 2022, 30(8): 1406-1411.
11.	Saylik F, Akbulut T. Systemic immune-inflammation index predicts major cardiovascular adverse events in patients with st-segment elevated myocardial infarction. Arq Bras Cardiol, 2022, 119(1): 14-22.
12.	阿布都拉·艾爾肯. 系統炎癥指數對冠心病PCI術后患者臨床結局的影響. 烏魯木齊: 新疆醫科大學, 2022.
13.	孔亞偉. 系統性免疫炎癥指數對冠狀動脈支架術后的心肌梗死患者臨床不良事件的影響. 鄭州: 鄭州大學, 2021.
14.	Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest, 2020, 50(5): e13230.
15.	Zhao J, Lv H, Yin D, et al. Systemic immune-inflammation index predicts long-term outcomes in patients with three-vessel coronary disease after revascularization: results from a large cohort of 3561 patients. J Inflamm Res, 2022, 15: 5283-5292.
16.	Orhan AL, ?ayl?k F, ?i?ek 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): 1687-1695.
17.	?cal L, Keskin M, Cer?it S, et al. Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction. Coron Artery Dis, 2022, 33(4): 251-260.
18.	Montarello NJ, Nguyen MT, Wong DTL, et al. Inflammation in coronary atherosclerosis and its therapeutic implications. Cardiovasc Drugs Ther, 2022, 36(2): 347-362.
19.	Ochijewicz D, Tomaniak M, Opolski G, et al. Inflammation as a determinant of healing response after coronary stent implantation. Int J Cardiovasc Imaging, 2021, 37(3): 791-801.
20.	Agarwal R, Aurora RG, Siswanto BB, et al. The prognostic value of neutrophil-to-lymphocyte ratio across all stages of coronary artery disease. Coron Artery Dis, 2022, 33(2): 137-143.
21.	Li XT, Fang H, Li D, et al. Association of platelet to lymphocyte ratio with in-hospital major adverse cardiovascular events and the severity of coronary artery disease assessed by the Gensini score in patients with acute myocardial infarction. Chin Med J (Engl), 2020, 133(4): 415-423.
22.	Villanueva DLE, Tiongson MD, Ramos JD, et al. Monocyte to high-density lipoprotein ratio (MHR) as a predictor of mortality and major adverse cardiovascular events (MACE) among ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis. Lipids Health Dis, 2020, 19(1): 55.
23.	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: 20-29.
24.	Jiang H, Li D, Xu T, et al. Systemic immune-inflammation index predicts contrast-induced acute kidney injury in patients undergoing coronary angiography: a cross-sectional study. Front Med (Lausanne), 2022, 9: 841601.
25.	Liu Y, Ye T, Chen L, et al. Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease. Coron Artery Dis, 2021, 32(8): 715-720.
26.	Ata Y, Abanoz M. Predictive roles of right coronary artery disease severity and systemic immune inflammation index in predicting atrial fibrillation after coronary bypass operations in patients with right coronary artery disease. Heart Surg Forum, 2021, 24(6): E977-E982.
27.	Candemir M, Kiziltun? E, Nurko? S, et al. Relationship between systemic immune-inflammation index (SII) and the severity of stable coronary artery disease. Angiology, 2021, 72(6): 575-581.
28.	Yekedüz E, Dogan ?, Kaya DM, et al. Systemic immune-inflammation index as a prognostic marker of late recurrence in operable gastric cancer: a dual-center study. J Gastrointest Cancer, 2022, 53(4): 870-879.
29.	Feng L, Xu R, Lin L, et al. Effect of the systemic immune-inflammation index on postoperative complications and the long-term prognosis of patients with colorectal cancer: a retrospective cohort study. J Gastrointest Oncol, 2022, 13(5): 2333-2339.
30.	Biyik M, Biyik Z, Asil M, et al. Systemic inflammation response index and systemic immune inflammation index are associated with clinical outcomes in patients with acute pancreatitis? J Invest Surg, 2022, 35(8): 1613-1620.
31.	Zhou YX, Li WC, Xia SH, et al. Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol, 2022, 13: 836595.
32.	Su S, Liu J, Chen L, et al. Systemic immune-inflammation index predicted the clinical outcome in patients with type-B aortic dissection undergoing thoracic endovascular repair. Eur J Clin Invest, 2022, 52(2): e13692.
33.	Hoyer FF, Nahrendorf M. Neutrophil contributions to ischaemic heart disease. Eur Heart J, 2017, 38(7): 465-472.
34.	D?ring Y, Soehnlein O, Weber C. Neutrophil extracellular traps in atherosclerosis and atherothrombosis. Circ Res, 2017, 120(4): 736-743.

1. Henein MY, Vancheri S, Longo G, et al. The role of inflammation in cardiovascular disease. Int J Mol Sci, 2022, 23(21): 12906.
2. González L, Bulnes JF, Orellana MP, et al. The role of colchicine in atherosclerosis: from bench to bedside. Pharmaceutics, 2022, 14(7): 1395.
3. Shaya GE, Leucker TM, Jones SR, et al. Coronary heart disease risk: low-density lipoprotein and beyond. Trends Cardiovasc Med, 2022, 32(4): 181-194.
4. Wang P, Guo X, Zhou Y, et al. Monocyte-to-high-density lipoprotein ratio and systemic inflammation response index are associated with the risk of metabolic disorders and cardiovascular diseases in general rural population. Front Endocrinol (Lausanne), 2022, 13: 944991.
5. Hu Q, Hisamatsu T, Haemmerle M, et al. Role of platelet-derived Tgfβ1 in the progression of ovarian cancer. Clin Cancer Res, 2017, 23(18): 5611-5621.
6. Dziedzic EA, G?sior JS, Tuzimek A, et al. Investigation of the associations of novel inflammatory biomarkers-systemic inflammatory index (SII) and systemic inflammatory response index (SIRI)-with the severity of coronary artery disease and acute coronary syndrome occurrence. Int J Mol Sci, 2022, 23(17): 9553.
7. 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, 33197221121435.
8. 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.
9. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10. 蔣愛民, 任夢迪, 馬宇彥, 等. 預后營養指數作為非小細胞肺癌預后因素的Meta分析. 現代腫瘤醫學, 2022, 30(8): 1406-1411.
11. Saylik F, Akbulut T. Systemic immune-inflammation index predicts major cardiovascular adverse events in patients with st-segment elevated myocardial infarction. Arq Bras Cardiol, 2022, 119(1): 14-22.
12. 阿布都拉·艾爾肯. 系統炎癥指數對冠心病PCI術后患者臨床結局的影響. 烏魯木齊: 新疆醫科大學, 2022.
13. 孔亞偉. 系統性免疫炎癥指數對冠狀動脈支架術后的心肌梗死患者臨床不良事件的影響. 鄭州: 鄭州大學, 2021.
14. Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest, 2020, 50(5): e13230.
15. Zhao J, Lv H, Yin D, et al. Systemic immune-inflammation index predicts long-term outcomes in patients with three-vessel coronary disease after revascularization: results from a large cohort of 3561 patients. J Inflamm Res, 2022, 15: 5283-5292.
16. Orhan AL, ?ayl?k F, ?i?ek 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): 1687-1695.
17. ?cal L, Keskin M, Cer?it S, et al. Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction. Coron Artery Dis, 2022, 33(4): 251-260.
18. Montarello NJ, Nguyen MT, Wong DTL, et al. Inflammation in coronary atherosclerosis and its therapeutic implications. Cardiovasc Drugs Ther, 2022, 36(2): 347-362.
19. Ochijewicz D, Tomaniak M, Opolski G, et al. Inflammation as a determinant of healing response after coronary stent implantation. Int J Cardiovasc Imaging, 2021, 37(3): 791-801.
20. Agarwal R, Aurora RG, Siswanto BB, et al. The prognostic value of neutrophil-to-lymphocyte ratio across all stages of coronary artery disease. Coron Artery Dis, 2022, 33(2): 137-143.
21. Li XT, Fang H, Li D, et al. Association of platelet to lymphocyte ratio with in-hospital major adverse cardiovascular events and the severity of coronary artery disease assessed by the Gensini score in patients with acute myocardial infarction. Chin Med J (Engl), 2020, 133(4): 415-423.
22. Villanueva DLE, Tiongson MD, Ramos JD, et al. Monocyte to high-density lipoprotein ratio (MHR) as a predictor of mortality and major adverse cardiovascular events (MACE) among ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis. Lipids Health Dis, 2020, 19(1): 55.
23. 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: 20-29.
24. Jiang H, Li D, Xu T, et al. Systemic immune-inflammation index predicts contrast-induced acute kidney injury in patients undergoing coronary angiography: a cross-sectional study. Front Med (Lausanne), 2022, 9: 841601.
25. Liu Y, Ye T, Chen L, et al. Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease. Coron Artery Dis, 2021, 32(8): 715-720.
26. Ata Y, Abanoz M. Predictive roles of right coronary artery disease severity and systemic immune inflammation index in predicting atrial fibrillation after coronary bypass operations in patients with right coronary artery disease. Heart Surg Forum, 2021, 24(6): E977-E982.
27. Candemir M, Kiziltun? E, Nurko? S, et al. Relationship between systemic immune-inflammation index (SII) and the severity of stable coronary artery disease. Angiology, 2021, 72(6): 575-581.
28. Yekedüz E, Dogan ?, Kaya DM, et al. Systemic immune-inflammation index as a prognostic marker of late recurrence in operable gastric cancer: a dual-center study. J Gastrointest Cancer, 2022, 53(4): 870-879.
29. Feng L, Xu R, Lin L, et al. Effect of the systemic immune-inflammation index on postoperative complications and the long-term prognosis of patients with colorectal cancer: a retrospective cohort study. J Gastrointest Oncol, 2022, 13(5): 2333-2339.
30. Biyik M, Biyik Z, Asil M, et al. Systemic inflammation response index and systemic immune inflammation index are associated with clinical outcomes in patients with acute pancreatitis? J Invest Surg, 2022, 35(8): 1613-1620.
31. Zhou YX, Li WC, Xia SH, et al. Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol, 2022, 13: 836595.
32. Su S, Liu J, Chen L, et al. Systemic immune-inflammation index predicted the clinical outcome in patients with type-B aortic dissection undergoing thoracic endovascular repair. Eur J Clin Invest, 2022, 52(2): e13692.
33. Hoyer FF, Nahrendorf M. Neutrophil contributions to ischaemic heart disease. Eur Heart J, 2017, 38(7): 465-472.
34. D?ring Y, Soehnlein O, Weber C. Neutrophil extracellular traps in atherosclerosis and atherothrombosis. Circ Res, 2017, 120(4): 736-743.

Chinese Journal of Evidence-Based Medicine

The relationship between systemic immune inflammatory index and prognosis of coronary heart disease: a meta-analysis

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