Prognostic Value Of Multiple Complete Blood Count-Derived Inflammatory Indices In Patients With Intermediate Coronary Artery Lesions

Objective:Multiple blood cell components are closely involved in the development and progression of atherosclerotic disease by mediating inflammatory response.Inflammatory indices derived from the complete blood counts(CBC)have been validated as prognostic factors in patients with coronary artery disease.The present study aimed to evaluate the prognostic value of multiple CBC-derived inflammatory indices among patients with intermediate coronary artery lesions.Methods:This retrospective cohort study successively selected hospitalized patients diagnosed with coronary stenosis of 50-70%by coronary angiography in Fuwai hospital.The primary endpoint was the composite of major adverse cardiovascular events(MACEs),including all-cause death,non-fatal myocardial infarction,and unplanned revascularization.7 CBC-derived indices[neutrophil-lymphocyte ratio(NLR),derived NLR(dNLR),monocyte-lymphocyte ratio(MLR),platelet-lymphocyte ratio(PLR),systemic immune inflammation index(SII),system inflammation response index(SIRI),and aggregate index of systemic inflammation(AISI)]were calculated at baseline.Results:The median follow-up time of this study was 6.11 years,and there were 189 cases of MACEs.Compared with the group without MACEs,those with MACEs were older,had higher rates of male,smoking,cardiovascular comorbidities,higher levels of various inflammatory markers,and had higher rates of multivessel lesions.Receiver-operating characteristic(ROC)curve analysis showed that SIRI predicted MACEs yielded the largest area under the curve than SII,NLR,dNLR and PLR,which was 0.614.Kaplan-Meier survival analyses showed that the cumulative incidence of MACEs increased significantly when each index was higher than the cut-off value(Log rank:P<0.001).COX multivariate regression analysis showed that,SIRI>0.72 and AISI>211.16 exhibited the closest interaction with MACEs among all the indices[SIRI,HR=1.588(1.138,2.212);AISI,HR=1.673(1.217,2.300)].Introducing each index respectively into the prediction model composed of traditional cardiovascular risk factors,the predictive ability of which can be improved significantly,and SIRI exhibited the best incremental value with the net reclassification index of 0.075(P=0.046)and integrated discrimination improvement of 0.011(P<0.001).Conclusions:Multiple CBC-derived inflammatory indices can provide prognostic value in patients with intermediate coronary artery lesions,and baseline SIRI or AISI exhibit the most stable and reliable prediction performance.