Prognostic implications of systemic immune-inflammation index in myocardial infarction patients with and without diabetes: insights from the NOAFCAMI-SH registry
Authors' conclusion
In AMI patients with DM, high SII is an independent predictor of poor survival and may be helpful for patient's risk stratification.
Study context
- Population
- Patients with acute myocardial infarction (AMI), February 2014 to March 2018, NOAFCAMI-SH registry; mean age 65.2 ± 12.2 years, 77.5% males, 789 (37.4%) with diabetes mellitus (DM)
- Participants
- 2,111 patients
- Exposure
- Higher vs lower SII, in patients with and without DM
- Outcome
- All-cause death and cardiovascular (CV) death
- Follow-up
- Median 2.5 years
Methodological detailsmultivariable Cox regression, multiple imputation for missing covariates
- Multivariable Cox regression
- Multiple imputation for missing covariates
Main finding
As reported in the abstract
All-cause death and CV death by SII, in patients with and without DM · median of 2.5 years of follow-up
Hazard ratio (95% CI)P value
Higher log-transformed SII (continuous)all-cause mortality, all patients
1.57(1.02–2.43)
Higher log-transformed SII (continuous)CV mortality, all patients
1.85(1.12–3.05)
Higher log-transformed SII (continuous)all-cause death, diabetics; not significant in nondiabetics
2.90(1.40–6.01)
Pinteraction for all-cause death 0.019Higher log-transformed SII (continuous)CV death, diabetics; not significant in nondiabetics
3.28(1.43–7.57)
Pinteraction for CV death 0.049Highest tertiles of SIIvs lowest tertiles of SIIall-cause mortality, all patients, multivariable-adjusted
1.82(1.19–2.79)
Highest tertiles of SIIvs lowest tertiles of SIICV mortality, all patients, multivariable-adjusted
1.82(1.19–2.79)
Highest tertiles of SIIvs lowest tertiles of SIIall-cause death, diabetics
2.00(1.13–3.55)
Highest tertiles of SIIvs lowest tertiles of SIICV death, diabetics
2.09(1.10–3.98)
Highest tertiles of SIIvs lowest tertiles of SIIall-cause death, nondiabetics
1.21(0.75–1.97)
Highest tertiles of SIIvs lowest tertiles of SIICV death, nondiabetics
1.60(0.89–2.90)
Observational data: associations, not effects.
Further findings
SII and CRP, peak TnT, LVEF (generalized additive model)
- As SII increased, CRP and peak TnT elevated while LVEF declined; similar with and without DM
Restricted cubic splines of SII and mortality
- Pronounced linear association between SII and mortality only in diabetics
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Prognostic implications of systemic immune-inflammation index in myocardial infarction patients with and without diabetes: insights from the NOAFCAMI-SH registry. Cardiovasc Diabetol. Published 22 January 2024. doi:10.
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