Systemic immune-inflammation index and high-sensitivity cardiac troponin T in acute coronary syndromes

Year 2021, , 218 - 225, 31.12.2021

Selcuk Ozturk , Mehmet Erdoğan , Yasar Turan

https://doi.org/10.30565/medalanya.936506

Cited By: 2

Abstract

Aim: Acute coronary syndromes (ACSs) are classified as ST-segment elevated myocardial infarction (STEMI), non-ST-segment elevated myocardial infarction (NSTEMI) and unstable angina pectoris (USAP). Cardiac troponins constitute the cornerstone biomarkers for the laboratory diagnosis of ACS. In this study, we aimed to investigate whether systemic immune-inflammation index (SII) is associated with peak cardiac troponin T (TnT) levels in ACS.

Methods: Consecutive patients with ACS whose coronary angiography was performed were included in the present study (n=397). Admission SII was determined as platelet count x neutrophil count/lymphocyte count. Serum levels of cardiac enzymes, including high-sensitivity TnT and creatine kinase-myocardial band (CK-MB), were measured at the time of admission and repeated daily during patients’ hospital stay.

Results: Patients were categorized as namely STEMI (n=92) and NSTEMI/USAP (n=141). The findings obtained in this study showed that the median of SII levels was higher in STEMI than NSTEMI/USAP at a significant level. Correlation analysis of SII with various clinical and laboratory parameters demonstrated a significant correlation with C-reactive protein, peak CK-MB (r=0.52, p<0.001), peak TnT (r=0.49, p<0.001) and left ventricular ejection fraction (r= -0.48, p<0.001). Multivariate linear regression analysis identified age and log-SII (Beta Coefficient: 1.29, 95% Confidence Interval: 0.93-1.66, p<0.001) as independent predictors of peak TnT levels.

Conclusion: SII is an independent predictor of peak TnT levels and significantly correlates with peak CK-MB levels in patients with ACS. SII significantly and inversely correlates with left ventricular systolic functions.

Keywords

Acute coronary syndrome, inflammation, systemic immune-inflammation index, troponin

Supporting Institution

N/A

Project Number

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Thanks

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Akut koroner sendromlarda sistemik immün-inflamasyon indeksi ve yüksek duyarlılıklı kardiyak troponin T

Abstract

Amaç: Akut koroner sendromlar (AKS), ST-segment yükselmeli miyokard enfarktüsü (STEMI), non-ST-segment yükselmeli miyokard enfarktüsü (NSTEMI) ve kararsız angina pektoris (USAP) olarak sınıflandırılır. Kardiyak troponinler AKS laboratuvar tanısı için temel biyolojik belirteçleri oluşturur. Biz bu çalışmada sistemik immün-inflamasyon indeksinin (SII) AKS' de zirve kardiyak troponin T (TnT) seviyeleri ile ilişkisini araştırmayı amaçladık.

Yöntem: Koroner anjiyografi yapılan AKS hastaları ardışık olarak çalışmaya dahil edildi (n=397). Başvuru anındaki SII değeri, trombosit sayısı x nötrofil sayısı / lenfosit sayısı olarak belirlendi. Yüksek duyarlılıklı TnT ve kreatin kinaz-miyokardiyal bandı (CK-MB) içeren serum kardiyak enzim seviyeleri başvuru sırasında ölçüldü ve ölçümler hastaların hastanede kaldıkları süre boyunca günlük olarak tekrarlandı.

Bulgular: Hastalar STEMI (n = 92) ve NSTEMI/USAP (n = 141) olarak kategorize edildi. SII ortanca değerleri STEMI grubunda NSTEMI/USAP grubundan anlamlı düzeyde daha yüksekti. SII' nin çeşitli klinik ve laboratuvar parametreleriyle yapılan korelasyon analizinde C-reaktif protein, zirve CK-MB (r = 0.52, p <0.001), zirve TnT (r = 0.49, p <0.001) ve sol ventrikül ejeksiyon fraksiyonu (r =-0.48, p <0.001) ile anlamlı bir korelasyon gösterdiği tespit edildi. Çok değişkenli doğrusal regresyon analizi yaş ve log transforme-SII' yi (Beta Katsayısı:1.29, % 95 Güven Aralığı:0.93-1.66, p<0.001) zirve TnT seviyelerinin bağımsız prediktörleri olarak tanımladı.

Sonuç: SII zirve TnT seviyelerinin bağımsız bir öngörücüsüdür ve AKS hastalarında zirve CK-MB seviyeleriyle anlamlı seviyede korelasyon göstermektedir. Ayrıca, SII sol ventrikül sistolik fonksiyonlarıyla anlamlı seviyede ters korelasyon göstermektedir.

Keywords

Akut koroner sendrom, inflamasyon, sistemik immün-inflamasyon indeksi, troponin

Project Number

N/A

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