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  4. Systemic immune-inflammation index predicts major adverse cardiovascular events in patients with ST-elevation myocardial infarction
 
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Titre

Systemic immune-inflammation index predicts major adverse cardiovascular events in patients with ST-elevation myocardial infarction

Type
abstract de conférence/colloque
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Série
European Heart Journal
Auteur(s)
Denegri, Andrea
Auteure/Auteur
Obeid, Slayman
Auteure/Auteur
Raeber, Lorenz
Auteure/Auteur
Windecker, S.
Auteure/Auteur
Gencer, Baris
Auteure/Auteur
Mach, F.
Auteure/Auteur
Rodondi, N.
Auteure/Auteur
Heg, Dik
Auteure/Auteur
Nanchen, David
Auteure/Auteur
Matter, C. M.
Auteure/Auteur
Klingenberg, Roland
Auteure/Auteur
Luescher, T. F.
Auteure/Auteur
Liens vers les personnes
Nanchen, David  
Liens vers les unités
PMU/UNISANTE  
Titre du livre ou conférence/colloque
ESC Congress 2021 – The Digital Experience 27–30 August 2021
Statut éditorial
Publié
Date de publication
2021
Volume
42
Numéro
SUPPL 1
Première page
1353
Langue
anglais
Notes
L636530384
2021-11-30
Résumé
Background: ST-elevation myocardial infarction (STEMI) represents the life-threatening manifestation of atherosclerosis, a chronic inflammatory disease of arterial wall, and is associated with high rate of morbidity and mortality. Thus, inflammatory biomarkers may be useful in identifying high inflammatory burden patients who may benefit from tailored high-intensity secondary prevention therapy. Purpose: We therefore assessed the relationship between the systemic immune-inflammation index (SII) and CV outcomesamong 1144 all-comers patients admitted to four Swiss University Hospital for STEMI and enrolled in the prospective multicenter SPUM registry cohort I (NCT 01000701). Methods: SII was calculated as platelet counts x neutrophil counts / lymphocyte counts. Patients were subdivided into three groups according to SII tertiles. The composite primary endpoint was major adverse cardiac and cerebrovascular events (MACCE: stroke, myocardial infarction, CV death). Adjusted Cox proportional hazards regression models were implemented to determine the risk associated with SII and outcomes. Results: Out of 1144 STEMI patients, 912 patients (79,7%) had available for SII. Patients within the highest tertile were slightly more frequently male (23.0 vs 22.0%, p=0.05), with higher plasma values of neutrophils (11.4±2.4 vs 6.5±3.7 G/l, p<0.001), platelets (275.3±97.5 vs 202.5±51.6 G/l, p<0.001) and lower levels of lymphocytes (1.0±0.6 vs 2.1±1.1 G/l, p<0.001) and LVEF (46.4±11.5% vs 50.4±10.3%, p<0.001) (Fig. 1A). At 1 year, these patients presented the highest rate of all-cause mortality (7.2% vs 2.6%, p=0.02) and MACCE (8.2% vs 3.3, p=0.03). This enhanced risk persisted for all-cause mortality and MACCE, after adjustment for age, sex, ace-inhibitors and statin therapy (Adj. HR 2.85, 95% CI 1.30-6.70, p=0.03 and Adj. HR 2.63, 95% CI 1.25-5.55, p=0.03, respectively, Fig. 1B). Conclusions: Among a real-world cohort of STEMI-patients, SII highlights the highest inflammatory risk phenotype, being associated with significant increased rates of MACCE and all-cause of death. These observations might help clinicians to furtherly identify patients who may derive the greatest benefit from tailored more intense secondary prevention therapies including inflammatory modulation. (Figure Presented).
Sujets

dipeptidyl carboxypep...

hydroxymethylglutaryl...

adult

all cause mortality

cerebrovascular accid...

cohort analysis

conference abstract

controlled study

drug combination

drug therapy

female

heart disease

heart left ventricle ...

human

human cell

human tissue

inflammation

lymphocyte count

major adverse cardiac...

major clinical study

male

multicenter study

neutrophil count

phenotype

platelet count

prospective study

secondary prevention

ST segment elevation ...

university hospital

PID Serval
serval:BIB_544F9AD1BF3E
DOI
10.1093/eurheartj/ehab724.1353
Permalien
https://iris.unil.ch/handle/iris/123667
URL éditeur
http://dx.doi.org/10.1093/eurheartj/ehab724.1353
Date de création
2021-12-07T14:50:23.847Z
Date de création dans IRIS
2025-05-20T20:21:04Z
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