Impact of the Pre-Procedural Pan-Immune Inflammation Value on Long-Term Mortality in Patients With Peripheral Artery Disease Following Endovascular Treatment: A Comparative Study

Abstract

Chronic inflammation significantly impacts the progression and prognosis of peripheral artery disease (PAD). The pan-immune inflammation value (PIV), an integrated biomarker reflecting various immune-inflammatory components, may provide superior prognostic insights for PAD patients treated by endovascular intervention. This retrospective analysis included 282 patients who underwent endovascular treatment for PAD between 2018 and 2022. Pre-procedural blood samples were used to calculate PIV and other inflammatory indices. The primary endpoint was long-term mortality, evaluated by receiver operating characteristic analyses and Cox proportional hazards modeling. PIV showed the highest predictive accuracy for mortality (area under curve [AUC] = 0.72), surpassing the neutrophil-to-lymphocyte ratio (NLR; AUC = 0.65), systemic immune-inflammation index (SII; AUC = 0.67), platelet-to-lymphocyte ratio (PLR; AUC = 0.61), and systemic inflammation response index (SIRI; AUC = 0.58). In multivariate analysis adjusted for significant confounders, pre-procedural PIV emerged as an independent predictor of mortality (HR [Hazard ratio]: 1.89; 95% CI: 1.42-2.51; P<.001). These findings highlight the superior clinical utility of PIV as a prognostic biomarker, demonstrating its enhanced effectiveness in risk stratification compared with other inflammatory indices such as NLR, SII, PLR, and SIRI in patients with PAD following endovascular intervention. The integration of PIV into routine clinical assessment may improve prognostic accuracy and facilitate more informed and individualized decision-making.