ABSTRACT

Objective:

The central role of inflammation in the pathogenesis of atherosclerotic cardiovascular diseases is increasingly recognized. Chronic inflammation emerges as a key factor in the underlying processes of atherosclerosis, directly influencing plaque formation, progression, and complications. The systemic immune-inflammatory index is a measure reflecting the immune response and has been associated with coronary artery disease. It is known that high-density lipoprotein cholesterol levels can reduce the risk of atherosclerosis. This study investigated whether the ratio of the systemic immune-inflammatory index to anti-inflammatory high-density lipoprotein is effective in predicting coronary artery disease in diagnosed patients.

Material and Methods:

This retrospective case-control study was conducted between October 2022 and May 2023 at our clinic among patients diagnosed with coronary artery disease through examinations (coronary computed tomography angiography and coronary angiography; case group: n=230) and those not diagnosed (control group: n=263). The presence of coronary artery disease was defined, consistent with previous studies, as a 50% or greater narrowing in the coronary artery.

Results:

Our study showed that the systemic immune-inflammatory index/high-density lipoprotein ratio was higher in the coronary artery disease group. Logistic regression analysis indicated that age, hypertension, diabetes, cholesterol levels, kidney function, and the systemic immune-inflammatory index/high-density lipoprotein ratio are independent predictors of coronary artery disease.

Conclusion:

The systemic immune-inflammatory index/high-density lipoprotein ratio has been shown as a potential index in determining coronary artery disease. This can provide clinicians with a fast, inexpensive, and effective screening test and may gain further importance in the future.

Keywords: Coronary artery disease, systemic immune inflammatory index, high density lipoprotein

References

Writing Group Members; Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016;133(4):e38-e360.

Kong P, Cui ZY, Huang XF, Zhang DD, Guo RJ, Han M. Inflammation and atherosclerosis: signaling pathways and therapeutic intervention. Signal Transduct Target Ther 2022;7(1):131.

Hansson GK, Robertson AK, Söderberg-Nauclér C. Inflammation and atherosclerosis. Annu Rev Pathol 2006;1:297-329.

GOFMAN JW, GLAZIER F, TAMPLIN A, STRISOWER B, DE LALLA O. Lipoproteins, coronary heart disease, and atherosclerosis. Physiol Rev 1954;34(3):589-607.

DELALLA OF, ELLIOTT HA, GOFMAN JW. Ultracentrifugal studies of high density serum lipoproteins in clinically healthy adults. Am J Physiol 1954;179(2):333-337.

Zhou L, Li C, Gao L, Wang A. High-density lipoprotein synthesis and metabolism (Review). Mol Med Rep 2015;12(3):4015-4021.

Ye Z, Hu T, Wang J, Xiao R, Liao X, Liu M, et al. Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: A systematic review and meta-analysis. Front Cardiovasc Med 2022;9:933913.

Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022;145(3):e4-e17.

Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023;41(12):1874-2071.

American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Care in Diabetes-2024. Diabetes Care 2024;47(Supplement_1):S5-S10.

Bäck M, Yurdagul A Jr, Tabas I, Öörni K, Kovanen PT. Inflammation and its resolution in atherosclerosis: mediators and therapeutic opportunities. Nat Rev Cardiol 2019;16(7):389-406.

Wang L, Cheng CK, Yi M, Lui KO, Huang Y. Targeting endothelial dysfunction and inflammation. J Mol Cell Cardiol 2022;168:58-67.

Libby P. Role of inflammation in atherosclerosis associated with rheumatoid arthritis. Am J Med 2008;121(10 Suppl 1):S21-S31.

Yang YL, Wu CH, Hsu PF, Chen SC, Huang SS, Chan WL, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020;50(5):e13230.

Liu Y, Ye T, Chen L, Jin T, Sheng Y, Wu G, et al. Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease. Coron Artery Dis 2021;32(8):715-720.

Libby P. Inflammatory mechanisms: the molecular basis of inflammation and disease. Nutr Rev 2007;65(12 Pt 2):S140-S146.

Bruce C, Chouinard RA Jr, Tall AR. Plasma lipid transfer proteins, high-density lipoproteins, and reverse cholesterol transport. Annu Rev Nutr 1998;18:297-330.

Durrington PN, Mackness B, Mackness MI. Paraoxonase and atherosclerosis. Arterioscler Thromb Vasc Biol 2001;21(4):473-480.

Smith JD, Trogan E, Ginsberg M, Grigaux C, Tian J, Miyata M. Decreased atherosclerosis in mice deficient in both macrophage colony-stimulating factor (op) and apolipoprotein E. Proc Natl Acad Sci U S A 1995;92(18):8264-8268.

Sima AV, Stancu CS, Simionescu M. Vascular endothelium in atherosclerosis. Cell Tissue Res 2009;335(1):191-203.

Sviridov D, Nestel P. Dynamics of reverse cholesterol transport: protection against atherosclerosis. Atherosclerosis 2002;161(2):245-254.

Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation 2003;107(1):139-146.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2224-2260.

Beverly JK, Budoff MJ. Atherosclerosis: Pathophysiology of insulin resistance, hyperglycemia, hyperlipidemia, and inflammation. J Diabetes 2020;12(2):102-104.

Poznyak A, Grechko AV, Poggio P, Myasoedova VA, Alfieri V, Orekhov AN. The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. Int J Mol Sci 2020;21(5):1835.

Can Systemic Immune Inflammatory Index/High Density Lipoprotein Ratio Predict Coronary Artery Disease?

ABSTRACT

References