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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1490498

Elevated systemic immune-inflammatory index predicts poor coronary collateralization in type 2 diabetic patients with chronic total occlusion

Provisionally accepted
Linshuang Mao Linshuang Mao Yixuan Wang Yixuan Wang Zhiming Wu Zhiming Wu Fenghua Ding Fenghua Ding Lin Lu Lin Lu Weifeng Shen Weifeng Shen Yang Dai Yang Dai Ying Shen Ying Shen *
  • Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

    Objective: This study compared the value of different systemic immune-inflammatory markers for evaluating coronary collateralization (CC) in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO).Methods: Systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and pan-immune-inflammation value (PIV) were calculated at admission in 1409 T2DM patients with CTO.The degree of coronary collaterals was estimated using the Rentrop scoring system and categorized into poor (Rentrop score 0 or 1) or good (Rentrop score 2 or 3) CC. The predictors of poor CC were determined by multivariate regression analysis, and the diagnostic potential of these indexes was analyzed by Receiver Operating Characteristic (ROC) curves.Results: SII, SIRI and PIV levels increased stepwise across Rentrop score 0 to 3, with significantly higher levels in patients with poor CC than in those with good CC (P< 0.001). After adjusting for confounders, SII, SIRI and PIV (per tertile) remained independent factors for poor CC. SII predicted poor CC better than SIRI and PIV (AUC: 0.758 vs 0.680 and 0.698, all P<0.001). There existed an interaction between blood concentration of HbA1c and SII (P<0.001), with high SII levels being associated with a greater risk (OR: 5.058 vs 2.444) and providing a better predictive ability for poor CC (AUC: 0.817 vs 0.731) in patients with HbA1c < 6.5% compared to those with HbA1c ≥ 6.5%.Conclusion: Our study shows that elevated SII provides a better prediction for poor CC in T2DM patients with CTO especially at good glycemic control.

    Keywords: systemic immune-inflammation index, coronary collateral circulation, type 2 diabetes mellitus, Stable coronary artery disease, chronic total occlusion

    Received: 03 Sep 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Mao, Wang, Wu, Ding, Lu, Shen, Dai and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ying Shen, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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