Value of Systemic Inflammatory Response Index as a Novel Prognostic Biomarker and Severity Assessment in Patients with Acute Coronary Syndrome

Abstract

Background: Over 15 million people died globally from acute coronary syndrome (ACS) in 2019, with individuals under 70 years old  accounting for 40% of these untimely fatalities.

Objective: To investigate the prognostic value of systemic inflammatory response index  (SIRI) in ACS patients as an independent risk factor for adverse events, and assessment severity of coronary artery disease.

Patients and  Methods: A prospective cohort study was conducted on 130 patients with ACS patients (ST-elevation myocardial infarction (STEMI), non- ST elevation myocardial infarction (NSTEMI), Unstable Angina). In addition to evaluation of SIRI, comprehensive clinical evaluations, lab  tests, and subsequent appointments were conducted for thorough analysis.

Results: The mean SIRI was 1.042 ± 0.4, the mean Syntax  Score was 18.77 ± 3.54. There was non- significant difference in between the two groups as regard to sex, age, SBP, DBP, and HR. There  was a significant difference in between survived and died cases as regard to family history, Killip class and number of vessels affected, and also, in between SYNTAX score more than 22 and below 22 as regard to troponin, creat, cholesterol, neutrophils, and monocytes. The  Sensitivity of SIRI and SYNTAX score as a predictor of outcome of ACS was 90% and 84.85%, the specificity was 94% and 82.69% and the  cut-off point was >0.744 and >22 respectively. There was a significant positive correlation in between SIRI and Age, Killip class, cholesterol,  lymphocytes, number of vessels affected, Syntax score, number of dead cases, number of non-fatal MI, and number of  strokes. According to the SIRI, univariate analysis showed that the most prevalent unfavourable outcome was death, non-fatal myocardial  infarction, and stroke.

Conclusions: SIRI could be used as an inflammatory biomarker for the prognosis of patients with ACS.