Increased Serum Systemic Immune-Inflammation Index is Independently Associated With Severity of Carotid Artery Stenosis

Stroke is a significant contributor to morbidity and mortality. The present study investigated how the systemic immune inflammation index (SII) could be used to predict the likelihood of developing carotid artery stenosis (CAS), which can be seen using carotid artery angiography (CAAG). This study comprised 418 individuals who underwent CAAG for CAS. SII was calculated by multiplying the platelet count by the neutrophil/lymphocyte ratio (NLR). The patients were divided into two groups: non-critical and critical CAS (stenosis below %70 and above ≥70%, respectively). Compared with the non-critical CAS, the critical CAS group had greater high sensitivity C-reactive protein levels (4.5 [3.1-5.7] vs 3.9 [2-5] [mg/L], P < .001), NLR (4.1 [2.9-7.5] vs 2.9 [1.8-3.7], P < .001), platelet/lymphocyte ratio (233 [110-297] vs 119 [96-197], P < .001), and SII (860 [608-2455] vs 604 [458-740], P < .001). Receiver Operating Characteristic Curve analysis demonstrated the best cutoff value of 672.3 for SII to predict the critical CAS with 71.2% sensitivity and 60.1% specificity. According to our study, an increase in SII is an independent predictor of the severity of CAS in patients undergoing CAAG.

[1]  Qiushi Lyu,et al.  High systemic immune-inflammation index is associated with carotid plaque vulnerability: New findings based on carotid ultrasound imaging in patients with acute ischemic stroke , 2022, Frontiers in Neurology.

[2]  Yilong Wang,et al.  Correlation of the systemic immune-inflammation index with short- and long-term prognosis after acute ischemic stroke , 2022, Aging.

[3]  N. Kalay,et al.  Predictive Values of Systemic Immune-Inflammation Index in New-Onset Atrial Fibrillation Following Coronary Artery Bypass Grafting , 2022, Brazilian journal of cardiovascular surgery.

[4]  N. Kalay,et al.  A Novel Predictor of Contrast-Induced Nephropathy in Patients With Carotid Artery Disease; the Systemic Immune Inflammation Index , 2022, Angiology.

[5]  Ann H. Kim,et al.  Elevated Neutrophil to Lymphocyte Ratio is Associated with Worse Outcomes after Carotid Endarterectomy in Asymptomatic Patients. , 2021, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[6]  S. Doğan,et al.  The Predictive Role of a Novel Risk Index in Patients Undergoing Carotid Artery Stenting: Systemic Immune-Inflammation Index. , 2021, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[7]  N. Kalay,et al.  Systemic immune inflammation index: a novel predictor for coronary collateral circulation , 2021, Perfusion.

[8]  Tingting Zhang,et al.  Systemic immune-inflammation index as a promising predictor of mortality in patients with acute coronary syndrome: a real-world study , 2021, The Journal of international medical research.

[9]  A. Yılmaz,et al.  Systemic immune-inflammation index is associated with increased carotid intima-media thickness in hypertensive patients , 2021, Clinical and experimental hypertension.

[10]  A. Dogan,et al.  Systemic Immune Inflammation Index: A Novel Predictor of Contrast-Induced Nephropathy in Patients With Non-ST Segment Elevation Myocardial Infarction , 2021, Angiology.

[11]  D. Heck,et al.  Carotid stenosis, stroke, and carotid artery revascularization. , 2021, Progress in cardiovascular diseases.

[12]  E. Kızıltunç,et al.  Relationship Between Systemic Immune-Inflammation Index (SII) and the Severity of Stable Coronary Artery Disease , 2021, Angiology.

[13]  X. Ye,et al.  Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS) , 2020, The International journal of neuroscience.

[14]  O. Argan,et al.  Increased Serum CRP-Albumin Ratio Is Independently Associated With Severity of Carotid Artery Stenosis , 2020, Angiology.

[15]  Yenn-Jiang Lin,et al.  Systemic immune‐inflammation index (SII) predicted clinical outcome in patients with coronary artery disease , 2020, European journal of clinical investigation.

[16]  M. E. Kooi,et al.  Prediction of Stroke Risk by Detection of Hemorrhage in Carotid Plaques: Meta-Analysis of Individual Patient Data. , 2020, JACC. Cardiovascular imaging.

[17]  M. Volpe,et al.  Highlights of ESC/ESH 2018 Guidelines on the Management of Hypertension: What Every Doctor Should Know , 2019, High Blood Pressure & Cardiovascular Prevention.

[18]  J. Raffort,et al.  High Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are Associated with Symptomatic Internal Carotid Artery Stenosis. , 2019, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[19]  K. Vandenbroeck,et al.  Inflammation in human carotid atheroma plaques. , 2018, Cytokine & growth factor reviews.

[20]  A. Pulvirenti,et al.  Neutrophil-to-Lymphocyte Ratio is a strong predictor of atherosclerotic carotid plaques in older adults. , 2018, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[21]  F. Uzunkaya,et al.  The correlation of the platelet-to-lymphocyte ratio with the severity of stenosis and stroke in patients with carotid arterial disease , 2017, Vascular.

[22]  Xuguang Gao,et al.  Neutrophil-to-Lymphocyte Ratio Correlates with Severity of Extracranial Carotid Stenosis-A Study Using Digital Subtraction Angiography. , 2017, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[23]  R. Safian.  Asymptomatic Carotid Artery Stenosis: Revascularization. , 2017, Progress in cardiovascular diseases.

[24]  D. Mikhailidis,et al.  The Relation Between Atherosclerosis and the Neutrophil–Lymphocyte Ratio , 2016, Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis.

[25]  R. Akdemir,et al.  Usefulness of the platelet‐to‐lymphocyte ratio in predicting the severity of carotid artery stenosis in patients undergoing carotid angiography , 2016, The Kaohsiung journal of medical sciences.

[26]  A. Nicolaides,et al.  Long-term Mortality in Patients with Asymptomatic Carotid Stenosis: Implications for Statin Therapy. , 2015, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[27]  M. Yarlıoglues,et al.  Impact of Serum Albumin Levels on Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention , 2015, Angiology.

[28]  O. Uysal,et al.  The Relationship Between Neutrophil-to-Lymphocyte Ratio and Coronary Collateral Circulation , 2015, Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis.

[29]  A. Wang,et al.  Associations of high sensitivity C‐reactive protein levels with the prevalence of asymptomatic intracranial arterial stenosis , 2014, European journal of neurology.

[30]  Suleyman Yazici,et al.  The relationship between complete blood count parameters and Fontaine’s Stages in patients with peripheral arterial disease , 2014, Vascular.

[31]  Z. Akpınar,et al.  Neutrophil lymphocyte ratio as a predictor of stroke. , 2013, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[32]  O. Uysal,et al.  Increased red cell distribution width level is associated with absence of coronary collateral vessels in patients with acute coronary syndromes. , 2013, Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir.

[33]  O. Uysal,et al.  Relation between mean platelet volume and coronary collateral vessels in patients with acute coronary syndromes. , 2013, Journal of cardiology.

[34]  Gary Friday,et al.  2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American , 2011, Journal of the American College of Cardiology.

[35]  E. Núñez,et al.  Relationship between low lymphocyte count and major cardiac events in patients with acute chest pain, a non-diagnostic electrocardiogram and normal troponin levels. , 2009, Atherosclerosis.

[36]  Nailin Li.  Platelet–lymphocyte cross‐talk , 2008, Journal of leukocyte biology.

[37]  G. Moneta,et al.  Prospective evaluation of the relationship between C-reactive protein, D-dimer and progression of peripheral arterial disease. , 2006, Journal of vascular surgery.

[38]  William Stewart,et al.  Recommendations for chamber quantification. , 2006, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[39]  C. Ballantyne,et al.  Markers of inflammation and their clinical significance. , 2005, Atherosclerosis. Supplements.

[40]  M. Goldstein,et al.  Endarterectomy for asymptomatic carotid artery stenosis. , 1995, JAMA.

[41]  M. Cybulsky,et al.  Endothelial expression of a mononuclear leukocyte adhesion molecule during atherogenesis. , 1991, Science.