Shanghai Jiaotong Daxue xuebao. Yixue ban (Mar 2024)
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
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.
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