Predictive value of systemic immune-inflammation index (SII) has been shown in clinical outcomes and complexity of coronary artery disease, acute coronary syndrome, and heart failure. We sight to evaluate value of SII in patients with lower extremity arterial disease (LEAD).
Methods
A total of 271 patients diagnosed with LEAD were included to our study. Blood samples of the patients were collected and analyzed for biochemical variables and complete blood count parameters. SII value of each patient was calculated. The complexity of atherosclerotic disease was classified according to Trans-Atlantic Inter-Society Consensus (TASC II) classification.
Results
Patients with TASC C-D were older than patients in TASC A-B group (63.06 ± 9.24 years and 60.85 ± 8.75 years, respectively). Other co-morbidities were comparable in both groups. Hemoglobin level and lymphocyte count were significantly lower, neutrophil, platelet counts, and SII values were significantly higher in patients with TASC C-D disease compared to that of patients with TASC A-B disease. SII showed significant correlation with the severity of LEAD (r = 0.363, p < .001). SII value of 664.24 predicted TASC C-D disease with a sensitivity and specificity of 60.8% and 73.3%, respectively. Results of multivariate logistic regression analysis showed that SII had higher odds ratio compared to platelet, neutrophil, and lymphocyte counts.
Conclusion
Higher SII may indicate probability of more complex LEAD. This relationship seems plausible in terms of similar pathophysiology of coronary artery disease and peripheral artery disease.
ErasoLHFukayaEMohlerER, et al.Peripheral arterial disease, prevalence and cumulative risk factor profile analysis. Eur J Prev Cardiol2014; 21(6): 704–711.
2.
BauersachsRZeymerUBrièreJB, et al.Burden of coronary artery disease and peripheral artery disease: a literature review. Cardiovasc Ther2019; 2019: 8295054.
3.
KattoorAJPothineniNVKPalagiriD, et al.Oxidative stress in atherosclerosis. Curr Atherosclerosis Rep2017; 19(11): 42.
4.
MadjidMWillersonJT. Inflammatory markers in coronary heart disease. Br Med Bull2011; 100: 23–38.
5.
RidkerPMCushmanMStampferMJ, et al.Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation1998; 97(5): 425–428.
6.
TzoulakiIMurrayGDLeeAJ, et al.C-reactive protein, interleukin-6, and soluble adhesion molecules as predictors of progressive peripheral atherosclerosis in the general population: Edinburgh Artery Study. Circulation2005; 112(7): 976–983.
7.
ArbelYFinkelsteinAHalkinA, et al.Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis2012; 225(2): 456–460.
8.
BhatTMAfariMEGarciaLA. Neutrophil lymphocyte ratio in peripheral vascular disease: a review. Expert Rev Cardiovasc Ther2016; 14(7): 871–875.
9.
VerdoiaMBarbieriLDi GiovineG, et al.Neutrophil to lymphocyte ratio and the extent of coronary artery disease: results from a large cohort study. Angiology2016; 67(1): 75–82.
10.
HaumerMAmighiJExnerM, et al.Association of neutrophils and future cardiovascular events in patients with peripheral artery disease. J Vasc Surg2005; 41(4): 610–617.
11.
CandemirMKiziltunçENurkoçS, et al.Relationship between systemic immune-inflammation index (SII) and the severity of stable coronary artery disease. Angiology2021; 72(6): 575–581.
12.
SuGZhangYXiaoR, et al.Systemic immune-inflammation index as a promising predictor of mortality in patients with acute coronary syndrome: a real-world study. J Int Med Res2021; 49(5): 3000605211016274.
13.
YangYLWuCHHsuPF, et al.Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest2020; 50(5): e13230.
14.
HuangJZhangQWangR, et al.Systemic immune-inflammatory index predicts clinical outcomes for elderly patients with acute myocardial infarction receiving percutaneous coronary intervention. Med Sci Mon Int2019; 25: 9690–9701.
15.
TangYZengXFengY, et al.Association of systemic immune-inflammation index with short-term mortality of congestive heart failure: a retrospective cohort study. Front Cardiovasc Med2021; 8: 753133.
16.
ZhangZChenZ. Higher systemic immune-inflammation index is associated with higher likelihood of peripheral arterial disease. Ann Vasc Surg2022; 84: 322–326.
17.
LibbyP. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol2012; 32(9): 2045–2051.
18.
VinereanuD. Risk factors for atherosclerotic disease: present and future. Herz2006; 3(S3): 5–24.
19.
NorgrenLHiattWRDormandyJA, et al.Inter-society Consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg2007; 45(Suppl S): S5–S67.
20.
OlinJWSealoveBA. Peripheral artery disease: current insight into the disease and its diagnosis and management. Mayo Clin Proc2010; 85(7): 678–692.
21.
WongBWMeredithALinD, et al.The biological role of inflammation in atherosclerosis. Can J Cardiol2012; 28(6): 631–641.
22.
CortiRHutterRBadimonJJ, et al.Evolving concepts in the triad of atherosclerosis, inflammation and thrombosis. J Thromb Thrombolysis2004; 17(1): 35–44.
GalkinaELeyK. Immune and inflammatory mechanisms of atherosclerosis. Annu Rev Immunol2009; 27: 165–197.
25.
BrevettiGGiuglianoGBrevettiL, et al.Inflammation in peripheral artery disease. Circulation2010; 122(18): 1862–1875.
26.
CauleyJAKassemAMLaneNE, et al.Prevalent peripheral arterial disease and inflammatory burden. BMC Geriatr2016; 16(1): 213.
27.
McDermottMMGuralnikJMCorsiA, et al.Patterns of inflammation associated with peripheral arterial disease: the InCHIANTI study. Am Heart J. 2005; 150(2): 276–281.
28.
MurabitoJMKeyesMJGuoCY, et al.Cross-sectional relations of multiple inflammatory biomarkers to peripheral arterial disease: the Framingham Offspring Study. Atherosclerosis2009; 203(2): 509–514.
29.
AykanAÇHatemEKalaycıoğluE, et al.Neutrophil-to-lymphocyte ratio may be a marker of peripheral artery disease complexity. Anatol J Cardiol2016; 16(7): 497–503.
30.
YeMQianXGuoX, et al.Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predict severity and prognosis of lower limb arteriosclerosis obliterans. Ann Vasc Surg2020; 64: 221–227.
31.
YangRChangQMengX, et al.Prognostic value of Systemic immune-inflammation index in cancer: a meta-analysis. J Cancer2018; 9(18): 3295–3302.
32.
LiuXGuanGCuiX, et al.Systemic immune-inflammation index (SII) can Be an early indicator for predicting the severity of acute pancreatitis: a retrospective study. Int J Gen Med2021; 14: 9483–9489.
33.
YunSYiHJLeeDH, et al.Systemic inflammation response index and systemic immune-inflammation index for predicting the prognosis of patients with aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis2021; 30(8): 105861.
34.
ZhouYXLiWCXiaSH, et al.Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol2022; 13: 836595.
35.
GagnonDZhangTBrandF, et al.Hematocrit and the risk of cardiovascular disease—the Framingham Study: a 34-year follow-up. Am Heart J1994; 127: 674–682.
36.
SarnakMJTighiouartHManjunathG, et al.Anemia as a risk factor for cardiovascular disease in the Atherosclerosis Risk in Communities (ARIC) study. J Am Coll Cardiol2002; 40(1): 27–33.
37.
ChoiYWonKBKangHH, et al.Association of serum hemoglobin level with the risk of carotid plaque beyond metabolic abnormalities among asymptomatic adults without major adverse clinical events: a cross-sectional cohort study. BMC Cardiovasc Disord2021; 21(1): 35.
38.
DijkJMWanggeGGraafY, et al.Hemoglobin and atherosclerosis in patients with manifest arterial disease. The SMART-study. Atherosclerosis2006; 188(2): 444–449.
