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

Abstract

Aim:This study aimed to evaluate the relationship between intracoronary thrombus burdenand systemic immune-inflammation index (SII) and to compare the predictive capacity of SIItogether with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) inpatients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneouscoronary 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 thrombusburden. According to the TIMI thrombus classification, 229 (54%) patients with low thrombusburden (grade 0–3) and 196 (46%) patients with high thrombus burden (grade 4 and 5) werecompared. SII was calculated as platelet neutrophil/lymphocyte counts.Results:High NLR (OR: 1.068, 95% CI:1.023–1.404;p¼0.031), PLR(OR: 1.012, 95% CI:1.002–1.018;p¼0.043), SII(OR: 1.325, 95% CI: 1.156–1.879;p¼0.015) and low left ventricle ejection fraction(LVEF) (OR: 0.957, 95% CI:0.924–0.990;p¼0.012) were found to be independent predictors ofhigh thrombus burden. SII values above 812 predicted a high thrombus burden with a sensitiv-ity of 82% and specificity of 73% (AUC: 0.836; 95% CI:0.795–0.877;p<0.001). This predictivenessof SII was stronger as compared to NLR (0.836 vs. 0.818,p¼0.043) and PLR (0.836 vs.0.780,p<0.001).Conclusion:SII is an independent predictor of high thrombus burden in patients with STEMI. Inaddition, SII is superior to NLR and PLR in this regard.