Systemic inflammatory index as a predictive marker for the severity of coronary artery disease in individuals with chro-nic kidney disease

Meng-Qi ZHAO; Yang ZHANG; Xin HUANG; Jian-Jun PENG

doi:10.26599/1671-5411.2024.10.002

摘要：Objective To evaluate the correlation between the inflammatory intensity,as indicated by the systemic inflammatory index(SⅡ),and the severity of coronary artery disease(CAD)in patients with chronic kidney disease(CKD). Methods A total of 280 CKD patients who underwent coronary angiography were enrolled.CAD was evaluated using the Gen-sini score(GS).Patients were divided into the low,medium and high SⅡ groups according to the tertiles of the SⅡ values.Logist-ic regression analysis was conducted to analyze the relationship between SⅡ and GS.The cutoff points for the sensitivity and spe-cificity of SⅡ in predicting GS were estimated by performing the receiver operating characteristic curve analysis. Results Patients in the higher SⅡ group had a higher prevalence of CAD(P=0.013).In addition,the high SⅡ group had more pa-tients with complex CAD(triple-vessel disease and/or left main coronary artery stenosis)and chronic total occlusion lesions,and more patients required revascularization(P＜0.05).Correlation analysis suggested a positive relationship between SⅡ and GS,and in comparison to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio,SⅡ displayed a stronger correlation with GS(r=0.332,P＜0.001).Multifactorial logistic regression analysis revealed that SⅡ is independently associated with the severity of CAD(adjusted OR=1.14,95％CI:1.08-1.21,P＜0.01),particularly among elderly patients(age＞65 years).Receiver operating charact-eristic curve analysis indicated that the optimal cutoff value for SⅡ in predicting severe coronary artery stenosis(GS＞60)was 6.01(sensitivity:76.30％,specificity:53.50％),with an area under the curve(AUC)of 0.705(95％CI:0.642-0.768,P＜0.001),which was sta-tistically significantly better than platelet-to-lymphocyte ratio(AUC=0.646,95％CI:0.579-0.713,P＜0.001)and neutrophil-to-lym-phocyte ratio(AUC=0.643,95％CI:0.574-0.712,P＜0.001). Conclusions In patients with CKD,SⅡ is independently associated with the severity of CAD,especially in individuals aged 65 ye-ars or older.Furthermore,SⅡ functions as a predictive marker for the severity of coronary lesions.