Hua Hou,1 Yujia Xu,2 Guangxin Chen,3 Haifeng Yao,4 Fangjie Bi5 

1School of Clinical Medicine, Binzhou Medical University, Binzhou, Shandong, People’s Republic of China; 2Department of Echocardiography, Zibo Central Hospital, Zibo, Shandong, People’s Republic of China; 3Department of Emergency, Zibo Central Hospital, Zibo, Shandong, People’s Republic of China; 4School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, People’s Republic of China; 5Department of Cardiology, Zibo Central Hospital, Zibo, Shandong, People’s Republic of China

Correspondence: Fangjie Bi, Department of Cardiology, Zibo Central Hospital, Zhangdian District - Communist Youth, League West Road No. 54, Zibo, Shandong, 255000, People’s Republic of China, Tel +86- 185 6029 3603, Email bfjyx7@sina.com

Background: The Systemic Inflammation Response Index (SIRI) and N-terminal Pro–B-type natriuretic peptide (NT-proBNP) have been proposed as reliable predictors of poor prognosis in cardiovascular disease and all-cause mortality, However, their validity has not been extensively evaluated in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA).
Patients and Methods: 259 patients diagnosed with MINOCA were enrolled in this study from January 2015 to December 2022, and serum levels of SIRI and NT-proBNP were detected. The primary endpoints were major adverse cardiovascular events (MACE). According to the occurrence of MACE during the follow-up period, patients were grouped into MACE and Non-MACE groups, and divided by the median values for SIRI and NT-proBNP into groups: low SIRI, high SIRI, low NT-proBNP, and high NT-proBNP.
Results: A statistically significant difference in the levels of SIRI and NT-proBNP was observed between the MACE group and the non-MACE group. Kaplan-Meier survival curve analysis revealed that patients with high SIRI and high NT-proBNP had a significantly higher risk of MACE (log-rank P < 0.001). Furthermore, even after adjusting for covariates, the high SIRI and high NT-proBNP were associated with an increased risk of MACE (P< 0.001, HR: 3.188, 95% CI 1.940– 5.241; P< 0.001, HR: 2.245, 95% CI 1.432– 3.519). Additionally, the combined prognosis prediction of SIRI and NT-proBNP was superior to a single prediction, and adding SIRI and NT-proBNP to the traditional risk factor model improved the model’s predictive value.
Conclusion: High levels of SIRI and NT-proBNP exhibit a significant correlation with an increased risk of MACE, thereby suggesting that SIRI can be used as a reliable inflammatory indicator for predicting the risk in MINOCA patients, with significantly improved prognostic value when combined with NT-proBNP.

Keywords: systemic inflammation response index, N-terminal pro–B-type natriuretic peptide, myocardial infarction with coronary nonobstructive, major adverse cardiac events, prognosis, risk assessment