Systemic Immune-Inflammation Index as a Predictor of Left Atrial Thrombosis in Nonvalvular Atrial Fibrillation.

Background: The systemic immune-inflammation index (SII) has recently been investigated for cardiovascular diseases. We aimed to evaluate the relationship between SII and left atrial thrombosis (LAT). Methods: This retrospective, case-control study recruited patients with nonvalvular atrial fibrillation (NVAF) who underwent transesophageal echocardiography (TEE) for LAT detection before cardioversion or catheter ablation at a tertiary hospital between 2012 and 2021. Demographic characteristics were obtained from the hospital data system. According to TEE findings, the patients were categorized into LAT (+) and (-) groups. Age, gender, history of chronic diseases, urea, creatinine, albumin, hemogram parameters, the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), SII, the CHADS2 score, the CHA2DS2-VASc score, echocardiographic parameters, antiaggregant-anticoagulant use, and nonparoxysmal atrial fibrillation were included and analyzed. Results: The study population consisted of 403 patients, including 228 men (56.6%), at a mean age of 60.84±12.26 years. A high white blood cell count (WBC) (OR, 1.26; 95% CI, 1.05 to 1.51; P=0.013), a high SII (OR, 1.00, 95% CI, 1.00 to 1.00; P=0.003), and a low ejection fraction (OR, 0.95; 95% CI, 0.90 to 0.99; P=0.018) were independent predictors of LAT (+). A spontaneous echo contrast (OR, 2.43; 95% CI, 1.35 to 4.39; P=0.003) was associated with LAT (+). SII values above 693.6 predicted LAT (+) with 71.6% sensitivity and 71.7% specificity (AUC, 0.77; P<0.001). The predictiveness of SII was similar to that of NLR (0.77 vs 0.74, P=0.093) but higher than PLR (0.77 vs 0.67; P<0.001) and WBC (0.77 vs 0.69; P=0.031). Conclusion: SII is an independent predictor of LAT in patients with NVAF.

Relationship Between Systemic Inflammation Index and No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction.

This study aimed to evaluate the relationship between no-reflow phenomenon and systemic inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI). A total of 785 patients were included. The thrombolysis in myocardial infarction (TIMI) flow degree has been used to describe the no-reflow phenomenon. The study population was divided into two groups regarding the presence of no-reflow phenomenon including 110 patients with no-reflow (TIMI frame count 0-2) and 675 patients without no-reflow (TIMI frame count 3). The NLR [6.6 (4.6-11.6) vs 3.2 (2.0-5.3); P < .001], PLR [175 (121.3-220) vs 102.6 (76.1-150.1); P < .001] and SII [1921(1225-2906) vs 738.5 (450.5-1293); P < .001] were significantly higher in the no-reflow group. High NLR (OR: 1.078, 95%CI: 1.027-1.397; P = .021), PLR (OR: 1.009, 95%CI: 1.003-1.021; P = .041) and SII (OR: 1.216, 95%CI: 1.106-1.942; P = .004) were found to be independently associated with no-reflow phenomenon. The comparison of the receiver-operating characteristic curves showed that area under the curve of SII was greater than that of NLR (.789 vs .766, P = .007) and PLR (.789 vs .759, P = .048). SII levels may predict no-reflow phenomenon better than NLR and PLR.

Relationship between intracoronary thrombus burden and systemic immune-inflammation index in patients with ST-segment elevation myocardial infarction.

AIM: This study aimed to evaluate the relationship between intracoronary thrombus burden and systemic immune-inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). PATIENT & METHODS: A total of 425 patients were included in the study. The clinical, laboratory, and demographic characteristics of the patients were recorded. The thrombus classification "Thrombolysis in myocardial infarction (TIMI)" was used to assess the intracoronary thrombus burden. According to the TIMI thrombus classification, 229 (54%) patients with low thrombus burden (grade 0-3) and 196 (46%) patients with high thrombus burden (grade 4 and 5) were compared. SII was calculated as platelet × neutrophil/lymphocyte counts. RESULTS: High NLR (OR: 1.068, 95% CI:1.023-1.404; p = 0.031), PLR(OR: 1.012, 95% CI:1.002-1.018; p = 0.043), SII(OR: 1.325, 95% CI: 1.156-1.879; p = 0.015) and low left ventricle ejection fraction (LVEF) (OR: 0.957, 95% CI:0.924-0.990; p = 0.012) were found to be independent predictors of high thrombus burden. SII values above 812 predicted a high thrombus burden with a sensitivity of 82% and specificity of 73% (AUC: 0.836; 95% CI:0.795-0.877; p < 0.001). This predictiveness of SII was stronger as compared to NLR (0.836 vs. 0.818, p = 0.043) and PLR (0.836 vs. 0.780, p < 0.001). CONCLUSION: SII is an independent predictor of high thrombus burden in patients with STEMI. In addition, SII is superior to NLR and PLR in this regard.

Relationship between the Atherogenic Index of Plasma and Nondipping Circadian Pattern in Hypertensive Patients.

BACKGROUND: Hypertension is a major cause of cardiovascular diseases. Many studies have pointed out that the atherogenic index of plasma (AIP), which demonstrates plasma atherogenicity, is correlated with all-cause mortality, cardiovascular morbidity, atherosclerosis, and severity of coronary artery disease. Within this context, we tried to evaluate the correlation between nondipping circadian pattern and AIP. METHODS: We enrolled 1,030 hypertensive patients (mean age: 53.6 ± 11.4) as part of the target population, separated into different groups based on the circadian blood pressure (BP) pattern taken from dipper and nondipper groups subsequent to 24-h ambulatory blood pressure monitoring (ABPM). We calculated the level of AIP using the log transformation of the ratio of triglyceride to high-density lipoprotein cholesterol. RESULTS: The AIP observed in the nondipper group was remarkably higher than those of the dipper group (p < 0.001). After measuring the 24-h ABPM, we determined that AIP had a weak but significant correlation with nighttime systolic BP (r = 0.090, p = 0.004) and nighttime diastolic BP (r = 0.073, p = 0.019). As for the analysis based on the multivariate logistic regression, high AIP and age were found to be independently associated with the presence of the nondipping pattern. CONCLUSION: AIP levels are higher in patients with nondipping pattern compared to dipper patients. Additionally, higher levels of AIP are independently associated with the presence of the nondipping pattern in hypertensive patients.

Evaluation of Whole Blood Viscosity in Patients with Aortic Sclerosis.

Background: Blood viscosity and aortic sclerosis (AS) are strong predictors of cardiovascular events. The effects of blood viscosity on AS have not been studied adequately. We aimed to investigate the potential connection between whole blood viscosity (WBV) and AS. Methods: AS was detected by transthoracic echocardiography. The estimation of WBV was carried out at both high shear rate (HSR) (208/s) and low shear rate (LSR) (0.5/s) by previously validated formulae using hematocrit (HcT) and total protein (TP) in g/L. WBV at HSR (208/s) is: (0.12 × HcT) + 0.17 (TP - 2.07) and WBV at LSR (0.5/s) is: (1.89 × HcT) + 3.76 (TP - 78.42). Comparisons of WBV at both HSR and LSR were made between patients with and without AS. Results: We included 94 patients with AS (male = 30.9%, mean age = 67.5 y) and 97 control subjects without AS (male =26.6%, mean age = 69.1 y). Almost all of the clinical, echocardiographic, and biochemical characteristics were similar, but TP values were significantly higher in the AS group than in the control group (72.9 ± 5 g/L vs. 75.8 ± 6.1 g/L; p value < 0.001). Hemoglobin and HcT levels were similar (p value = 0.604 and p value = 0.431, respectively). In the AS group, WBV at LSR and HSR was higher than that in the control group (p value = 0.001 for both LSR and HSR). In multiple stepwise logistic regression analysis, WBV was an independent predictor of AS (p value < 0.001). Conclusion: We found higher WBV in patients with AS than in patients without AS at both LSR (0.5/s) and HSR (208/s). WBV at both LSR and HSR was independently associated with AS.