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已发表论文
系统免疫炎症指数与低密度脂蛋白胆固醇在急性心肌梗死行直接经皮冠状动脉介入治疗患者中的联合预后价值
Authors Zhang X, Liu A, Li C, Pan Y, Jiao S, Wang Y, Pu H, Liu Y, Zhu H, Pan D
Received 17 May 2025
Accepted for publication 11 November 2025
Published 27 November 2025 Volume 2025:18 Pages 16579—16596
DOI https://doi.org/10.2147/JIR.S541090
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Qing Lin
Xiuli Zhang,1,* Ailin Liu,1,* Chenyang Li,1 Yanqing Pan,1 Songsong Jiao,2 Yumin Wang,1 Huijuan Pu,1 Yan Liu,1 Hong Zhu,1 Defeng Pan1
1Department of Cardiology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, People’s Republic of China; 2Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
*These authors contributed equally to this work
Correspondence: Defeng Pan, Department of Cardiology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +8617660752236, Email xzdefengpan@xzhmu.edu.cn Hong Zhu, Department of Cardiology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +8613092323326, Email hongzhu0509@163.com
Background: The combined prognostic impact of the systemic immune-inflammation index (SII) and low-density lipoprotein cholesterol (LDL-C) after primary percutaneous coronary intervention (PPCI) in acute myocardial infarction (AMI) remains unclear. We evaluated their joint predictive value for clinical outcomes.
Methods: We retrospectively analyzed 487 AMI patients who underwent PPCI at the Affiliated Hospital of Xuzhou Medical University between January 2019 and December 2021. SII and LDL-C were assessed at baseline and 1 month post-discharge. Using the guideline LDL-C target (< 1.4 mmol/L or ≥ 50% reduction) and a receiver operating characteristic (ROC)–derived optimal SII cutoff (676.6 × 109 /L), patients were categorized as: both on-target, SII on-target only, LDL-C on-target only, or both off-target. The primary endpoint was the composite of major adverse cardiovascular events (MACEs): all-cause death, recurrent myocardial infarction, repeat revascularization, and ventricular arrhythmias. Candidate variables were selected with least absolute shrinkage and selection operator (LASSO); survival was analyzed using Cox proportional hazards models and Kaplan–Meier estimates.
Results: Versus the both off-target group, the both on-target group had significantly better outcomes (P < 0.001). The SII on-target only group also outperformed the LDL-C on-target only group (P < 0.001). Consistently, the both off-target group had markedly worse outcomes relative to the both on-target group (HR = 69.2; 95% CI: 16.8– 285.0; P < 0.001). At 1 month, SII showed good discrimination for MACEs (AUC = 0.76).
Conclusion: One month after PPCI, simultaneous achievement of SII and LDL-C targets was associated with a substantially lower 1-year risk of MACEs. Combined control of inflammation and lipids provided incremental benefit beyond lipid lowering alone, supporting a dual-target strategy in secondary prevention.
Keywords: systemic immune-inflammation index, low-density lipoprotein cholesterol, dual-target management, acute myocardial infarction, prognosis
1Department of Cardiology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, People’s Republic of China; 2Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
*These authors contributed equally to this work
Correspondence: Defeng Pan, Department of Cardiology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +8617660752236, Email xzdefengpan@xzhmu.edu.cn Hong Zhu, Department of Cardiology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +8613092323326, Email hongzhu0509@163.com
Background: The combined prognostic impact of the systemic immune-inflammation index (SII) and low-density lipoprotein cholesterol (LDL-C) after primary percutaneous coronary intervention (PPCI) in acute myocardial infarction (AMI) remains unclear. We evaluated their joint predictive value for clinical outcomes.
Methods: We retrospectively analyzed 487 AMI patients who underwent PPCI at the Affiliated Hospital of Xuzhou Medical University between January 2019 and December 2021. SII and LDL-C were assessed at baseline and 1 month post-discharge. Using the guideline LDL-C target (< 1.4 mmol/L or ≥ 50% reduction) and a receiver operating characteristic (ROC)–derived optimal SII cutoff (676.6 × 109 /L), patients were categorized as: both on-target, SII on-target only, LDL-C on-target only, or both off-target. The primary endpoint was the composite of major adverse cardiovascular events (MACEs): all-cause death, recurrent myocardial infarction, repeat revascularization, and ventricular arrhythmias. Candidate variables were selected with least absolute shrinkage and selection operator (LASSO); survival was analyzed using Cox proportional hazards models and Kaplan–Meier estimates.
Results: Versus the both off-target group, the both on-target group had significantly better outcomes (P < 0.001). The SII on-target only group also outperformed the LDL-C on-target only group (P < 0.001). Consistently, the both off-target group had markedly worse outcomes relative to the both on-target group (HR = 69.2; 95% CI: 16.8– 285.0; P < 0.001). At 1 month, SII showed good discrimination for MACEs (AUC = 0.76).
Conclusion: One month after PPCI, simultaneous achievement of SII and LDL-C targets was associated with a substantially lower 1-year risk of MACEs. Combined control of inflammation and lipids provided incremental benefit beyond lipid lowering alone, supporting a dual-target strategy in secondary prevention.
Keywords: systemic immune-inflammation index, low-density lipoprotein cholesterol, dual-target management, acute myocardial infarction, prognosis