Predictive value of systemic immune inflammation index and somatic symptom scale-China in the occurrence of in-hospital major adverse cardiovascular events after first-episode of acute myocardial infarction undergoing PCI

doi:10.3969/j.issn.1674-8115.2024.03.005

Abstract

Abstract:

Objective ·To investigate the predictive value of systemic inflammatory index (SII) and somatization symptom score-China (SSS-CN) for major adverse cardiovascular events (MACEs) in patients with first-episode acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods ·Three hundred and five first-episode AMI patients who received PCI treatment at the Cardiology Department of Anhui Second People's Hospital from September 2021 to September 2023 were included in the study. Enrolled patients were divided into MACEs group (n=203) and non-MACEs group (n=102) based on whether MACEs events occurred during hospitalization. Descriptive statistical analysis was performed on the general data such as gender, age and laboratory test results of the two groups of patients, and binary Logistic regression test was conducted for statistically significant items according to the analysis results. According to the results, receiver operating characteristic (ROC) curves were further drawn to evaluate the value of SII and SSS-CN in predicting the occurrence of MACEs in hospital. On this basis, coronary syntax score (SS) was combined to evaluate the predictive efficacy of the three combinations, and the optimal cut-off value was determined according to the maximum Jordan index. Results ·A total of 203 patients had MACEs events, among whom 179 (88.1%) had heart failure, 16 (7.9%) had severe arrhythmia, 4 (2.0%) had shock, 2 (1.0%) had recurrent myocardial infarction, and 2 (1.0%) died. Compared with the non-MACEs group, the SII and SSS-CN scores in the MACEs group were significantly increased (1 925.86 vs 934.23, 38.57 vs 23.30; both P<0.05). The binary Logistic results suggested that both SII and SSS-CN were independent risk factors for the occurrence of MACEs. The ROC curve results showed that the prediction efficiency was the best when SII ≥ 952, with a sensitivity of 64.0% and a specificity of 62.7% (AUC 0.675, 95% CI 0.612?0.737). The prediction efficiency was the best when SSS-CN ≥ 28.5, with a sensitivity of 80.7% and a specificity of 77.5% (AUC 0.840, 95% CI 0.794?0.886). The predictive performance was further improved after combining the syntax score (AUC 0.898, 95% CI 0.862?0.933). Conclusion ·The admission SII and SSS-CN scores of first-episode AMI patients are independent risk factors for the occurrence of MACEs during hospitalization after PCI. Early monitoring of SII changes in first-episode AMI patients after PCI or SSS-CN scores for patients with obvious Somatization symptoms can help identify high-risk patients for the occurrence of MACEs in the hospital.

Key words: systemic immune inflammation index (SII), somatization symptom score-China (SSS-CN), first episode of acute myocardial infarction, major adverse cardiovascular event (MACE), percutaneous coronary intervention (PCI)

CLC Number:

R541

ZHENG Mengyi, MAO Jialiang, ZOU Zhiguo, ZHANG Ruilei, ZHANG Hou, LI Shiguang. Predictive value of systemic immune inflammation index and somatic symptom scale-China in the occurrence of in-hospital major adverse cardiovascular events after first-episode of acute myocardial infarction undergoing PCI[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(3): 334-341.

Figures/Tables 5

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References 31

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Clinical data	MACEs group (n=203)	non-MACEs group (n=102)	P value
Age/year	68.13±19.92	53.97±12.02	0.010
Female/n(%)	63 (31.0)	13 (12.8)	0.000
Hospital stay/d	11.78±5.36	9.11±2.27	0.010
SII/(×10⁹·L^-1)	1 925.86±286.23	934.23±45.96	0.010
SSS-CN	38.57±11.78	23.30±9.59	0.000
SS	15.56±8.36	12.07±6.07	0.000
Multiple vessel lesions/n(%)	179 (88.2)	67 (65.7)	0.010
NT-Pro BNP/(ng·L^-1)	2 033.53±301.36	358.49±149.84	0.000
TnI/(μg·L^-1)	42.46±76.53	18.26±80.63	0.011
Killip rating≥Ⅱ/n(%)	102 (50.2)	20 (19.6)	0.000
Neutrophil /(×10⁹·L^-1)	7.94±3.47	6.76±2.83	0.002
Lymphocyte/(×10⁹·L^-1)	1.52±0.98	1.77±0.79	0.027
Platelet/(×10⁹·L^-1)	222.17±56.93	245.23±75.56	0.039
Usage of NE/n(%)	77 (37.9)	4 (3.9)	0.000
Admitted SBP/mmHg	129.33±23.41	136.83±23.90	0.040
Admitted DBP/mmHg	79.81±15.73	86.41±17.05	0.000
Diabetes/n(%)	79 (38.9)	26 (25.4)	0.005
Apoplexy/n(%)	46 (22.7)	11 (10.8)	0.002
Left main trunk/n(%)	37 (18.2)	15 (14.7)	0.737
CK/(U·L^-1)	840.00±99.76	706.00±119.52	0.405
CK-MB/(U·L^-1)	80.72±8.03	79.10±13.43	0.912
Hypertension/n(%)	141 (69.5)	65 (63.7)	0.066
Hyperlipidemia/n(%)	43 (21.2)	30 (29.4)	0.209

Clinical data	MACEs group (n=203)	non-MACEs group (n=102)	P value
Age/year	68.13±19.92	53.97±12.02	0.010
Female/n(%)	63 (31.0)	13 (12.8)	0.000
Hospital stay/d	11.78±5.36	9.11±2.27	0.010
SII/(×10⁹·L^-1)	1 925.86±286.23	934.23±45.96	0.010
SSS-CN	38.57±11.78	23.30±9.59	0.000
SS	15.56±8.36	12.07±6.07	0.000
Multiple vessel lesions/n(%)	179 (88.2)	67 (65.7)	0.010
NT-Pro BNP/(ng·L^-1)	2 033.53±301.36	358.49±149.84	0.000
TnI/(μg·L^-1)	42.46±76.53	18.26±80.63	0.011
Killip rating≥Ⅱ/n(%)	102 (50.2)	20 (19.6)	0.000
Neutrophil /(×10⁹·L^-1)	7.94±3.47	6.76±2.83	0.002
Lymphocyte/(×10⁹·L^-1)	1.52±0.98	1.77±0.79	0.027
Platelet/(×10⁹·L^-1)	222.17±56.93	245.23±75.56	0.039
Usage of NE/n(%)	77 (37.9)	4 (3.9)	0.000
Admitted SBP/mmHg	129.33±23.41	136.83±23.90	0.040
Admitted DBP/mmHg	79.81±15.73	86.41±17.05	0.000
Diabetes/n(%)	79 (38.9)	26 (25.4)	0.005
Apoplexy/n(%)	46 (22.7)	11 (10.8)	0.002
Left main trunk/n(%)	37 (18.2)	15 (14.7)	0.737
CK/(U·L^-1)	840.00±99.76	706.00±119.52	0.405
CK-MB/(U·L^-1)	80.72±8.03	79.10±13.43	0.912
Hypertension/n(%)	141 (69.5)	65 (63.7)	0.066
Hyperlipidemia/n(%)	43 (21.2)	30 (29.4)	0.209

Factor	Multivariate analysis
Factor	B	SE	Wald χ²	P value	OR (95% CI)
Age	0.043	0.016	7.114	0.008	1.044 (1.012‒1.078)
Gender	0.208	0.516	0.162	0.687	1.231 (0.448‒3.380)
SII	0.001	0.001	4.609	0.032	1.001 (1.001‒1.002)
SSS-CN	0.13	0.020	41.331	0.000	1.138 (1.094‒1.184)
SS	0.103	0.030	11.628	0.001	1.109 (1.045‒1.176)
Multiple vessel lesions	0.331	0.459	0.518	0.472	1.392 (0.566‒3.423)
NT-Pro BNP	0.001	0.000	5.046	0.025	1.001 (1.001‒1.002)
Diabetes	-0.802	0.276	8.432	0.004	0.449 (0.261‒0.771)
Apoplexy	1.027	0.372	7.609	0.006	2.792 (1.346‒5.792)
Admitted SBP	-0.001	0.008	0.026	0.872	0.999 (0.984‒1.014)
Admitted DBP	-0.019	0.011	2.833	0.092	0.981 (0.960‒1.003)
Usage of NE	2.217	0.541	16.794	0.000	9.176 (3.179‒26.489)

Factor	Multivariate analysis
Factor	B	SE	Wald χ²	P value	OR (95% CI)
Age	0.043	0.016	7.114	0.008	1.044 (1.012‒1.078)
Gender	0.208	0.516	0.162	0.687	1.231 (0.448‒3.380)
SII	0.001	0.001	4.609	0.032	1.001 (1.001‒1.002)
SSS-CN	0.13	0.020	41.331	0.000	1.138 (1.094‒1.184)
SS	0.103	0.030	11.628	0.001	1.109 (1.045‒1.176)
Multiple vessel lesions	0.331	0.459	0.518	0.472	1.392 (0.566‒3.423)
NT-Pro BNP	0.001	0.000	5.046	0.025	1.001 (1.001‒1.002)
Diabetes	-0.802	0.276	8.432	0.004	0.449 (0.261‒0.771)
Apoplexy	1.027	0.372	7.609	0.006	2.792 (1.346‒5.792)
Admitted SBP	-0.001	0.008	0.026	0.872	0.999 (0.984‒1.014)
Admitted DBP	-0.019	0.011	2.833	0.092	0.981 (0.960‒1.003)
Usage of NE	2.217	0.541	16.794	0.000	9.176 (3.179‒26.489)

Factor	SII<952 (n=137)	SII≥952 (n=168)	P value
Age/year	61.74±4.11	64.83±1.16	0.470
MACE/n(%)	71 (51.8)	128 (76.2)	0.000
SSS-CN	30.45±11.83	35.92±13.81	0.000
SS	10.73±6.33	18.85±8.01	0.020
NT-Pro BNP/(ng·L^-1)	742.11±137.66	2 062.34±360.38	0.020
Killip rating≥Ⅱ/n(%)	42 (30.7)	80 (47.6)	0.002