The Predictive and Prognostic Value of the Systemic Immune-Inflammation Index for Congestive Heart Failure

Zhihao Zheng; Shanshan Shi; Zechen Liu; Yanjun Song; Zhen'ge Chang; Kongyong Cui; Chenxi Song; Jia Li; Kefei Dou

doi:10.31083/j.rcm2511417

The Predictive and Prognostic Value of the Systemic Immune-Inflammation Index for Congestive Heart Failure

Rev Cardiovasc Med. 2024 Nov 21;25(11):417. doi: 10.31083/j.rcm2511417. eCollection 2024 Nov.

Authors

Zhihao Zheng^{1

2

3}, Shanshan Shi^{1

2

3}, Zechen Liu^{1

2

3}, Yanjun Song^{1

2

3}, Zhen'ge Chang⁴, Kongyong Cui^{1

2

3}, Chenxi Song^{1

2

3}, Jia Li^{1

2

3}, Kefei Dou^{1

2

3}

Affiliations

¹ Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.
² State Key Laboratory of Cardiovascular Disease, 102308 Beijing, China.
³ National Clinical Research Center for Cardiovascular Diseases, 100101 Beijing, China.
⁴ Department of Respiratory Medicine, Civil Aviation General Hospital, 100123 Beijing, China.

Abstract

Background: The systemic immune-inflammatory index (SII), calculated by (platelet count × neutrophil count)/lymphocyte count, is a novel biomarker with predive and prognostic value in numerous diseases. However, the relationship between SII and congestive heart failure (CHF) is not clear. This study aims to document the association of SII with the prevalence of CHF in the whole population and the long-term prognosis in CHF patients.

Methods: This study included 57,500 participants in the National Health and Nutritional Examination Surveys, who were categorized into 3 categories based on their SII levels. A cross-sectional study was conducted to examine the relationship between SII and CHF prevalence in the whole population, followed by a prospective longitudinal study with a 5.4-year follow-up period for CHF patients to assess the predictive significance of SII for CHF. The main focus of the longitudinal study was on all-cause death as the primary outcome, with cardiovascular (CV) death as the secondary outcome. Associations were estimated using multivariate logistic regression and Cox proportional hazards models. The dose-response relationship was assessed with the restricted cubic spline (RCS) analysis.

Results: In the cross-sectional analysis, there were 1927 (3.35%) participants diagnosed with CHF. The high SII group showed a significantly higher prevalence of CHF than the low SII group (odds ratio (OR) 1.24, 95% confidence interval (CI): 1.05, 1.45). In the longitudinal analysis, 882 all-cause deaths including 379 CV deaths were collected among CHF patients, and high SII was associated with a significant increase in the risk of all-cause death (hazard ratio (HR) 1.44; 95% CI: 1.14, 1.81) and CV death (HR 1.31; 95% CI: 1.08, 1.58). RCS confirmed the positive correlation of SII with the prevalence of CHF in the whole population, as well as the mortality risk in CHF patients.

Conclusions: This study is the first to reveal that high SII was related to a high prevalence of CHF and a poor prognosis in CHF patients. These findings underscore the potential role of SII in the prevention and management of CHF.

Keywords: NHANES; heart failure; inflammation; prediction; systemic immune-inflammation index.

Grants and funding

This work was supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (grant no. 2021-I2M-1-008).