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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1419314

Association of systemic immune-inflammatory index with in-stent restenosis in patients with and without diabetes mellitus

Provisionally accepted
Xunwei Deng Xunwei Deng 1,2,3*Qiaoting Deng Qiaoting Deng 1,2,3Qunji Zhang Qunji Zhang 1,2,3Jingyuan Hou Jingyuan Hou 1,2,3
  • 1 Department of Research Experimental Center, Meizhou People's Hospital, Meizhou, China
  • 2 Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China
  • 3 Cardiovascular Disease Research Institute, Meizhou Academy of Medical Sciences, Meizhou, China

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

    Background: Systemic inflammation plays a vital role in the pathogenesis and prognosis of cardiovascular disease (CAD). The systemic immune-inflammation index (SII) has been developed as a cost-effective and practical predictor for CAD outcomes. This study aimed to determine the association between the SII and the risk of ISR among ACS patients with and without diabetes mellitus (DM).In this study, a total of 1,652 patients who underwent percutaneous coronary intervention (PCI) from February 2015 to December 2020 and were finally enrolled. The SII was calculated based on neutrophil, platelet and lymphocyte counts. Multivariable logistic regression models were employed to assess the associations between SII and ISR prevalence. Additionally,restricted cubic splines analysis was applied to visualize the relationship between the SII and the risk of ISR.In the whole cohort enrolled in this study, 128 (7.7%) participants developed angiographic evidence of ISR. The results demonstrated that the SII level significantly increased in patients with ISR compared to those with non-ISR. After adjusting for confounders, the multivariate logistic regression analysis revealed that participants with higher SII levels had a significantly increased risk of ISR for diabetics (all P < 0.05), and this significant association was observed in patients with more severe ISR (triple-coronary artery lesions). Additionally, RCS analysis reveals that there is a J-shaped nonlinear correlation between SII and ISR in the entire study cohort with (P for overall < 0.001, and P for nonlinearity = 0.0058, respectively). Moreover, a threshold effect can be observed in the entire cohort, with an inflection point at the log2-SII value of 9.276 (SII = 620). Specifically, increased SII was linearly associated with ISR in diabetics (P for overall = 0.0007 and P for nonlinearity = 0.4316, respectively), indicating that the correlation between SII and ISR is stronger in diabetic patients than in those without diabetes.Our study suggests that SII may be an affordable and convenient marker that could be applied to predict the risk of ISR. Moreover, the study emphasized that high SII is an independent predictor of more severe and earlier ISR and may be helpful for patients' risk stratification, especially those with comorbid DM.

    Keywords: Systemic immune-inflammatory index, In-stent Restenosis, Diabetes Mellitus, Restricted cubic spline, Nonlinear relationship

    Received: 25 Apr 2024; Accepted: 02 Jan 2025.

    Copyright: © 2025 Deng, Deng, Zhang and Hou. 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: Xunwei Deng, Department of Research Experimental Center, Meizhou People's Hospital, Meizhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.