Association between pan-immune-inflammation value and no-reflow in patients with ST elevation myocardial infarction undergoing percutaneous coronary intervention

Scand J Clin Lab Invest. 2023 Oct;83(6):384-389. doi: 10.1080/00365513.2023.2241131. Epub 2023 Jul 27.

Abstract

Noreflow is a condition associated with a poor prognosis in ST segment elevation myocardial infarction patients. It has been shown that many inflammatory markers and index such as procalcitonin, C-reactive protein, neutrophil to lymphocyte ratio, systemic immune inflammatory index (SII), are associated with noreflow. We used a brand-new index pan-immune-inflammation value (PIV) to retrospectively evaluate the relationship between PIV and noreflow. A total of 1212 patients were included for analysis. Noreflow was observed in 145 patients. In multivariate analysis, PIV (odds ratio (OR): 1.025; [1.002-1.115], p < 0.001), baseline ejection fraction (OR: 0.963; [0.934-0.993], p = 0.015), stent length (OR: 1.032; [1.010-1.054], p = 0.004), age (OR: 1.034; [1.014-1.053], p = 0.001) and pain to PCI time (OR: 1.003 [1.002-1.005], p < 0.001) were observed to be the independent predictors of noreflow. ROC curve analysis showed that the best cut off value of PIV for predicting noreflow was ≥889 with 77.2% sensitivity and 77.5% specificity (AUC, 0.828; 95% CI [0.806-0.849]). A ROC curve comparison analysis was performed to compare PIV and SII. The predictive power of PIV was higher than SII (differences between areas: 0.154; p < 0.001). According to our findings, an increase in PIV is an independent predictor of noreflow in patients with STEMI.

Keywords: Pan-Immune-Inflammation value; ST- elevation myocardial infarction; noreflow; percutaneous coronary ıntervention; systemic immune inflammatory index.

MeSH terms

  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Female
  • Humans
  • Inflammation* / blood
  • Inflammation* / immunology
  • Lymphocytes / immunology
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neutrophils / immunology
  • Neutrophils / pathology
  • No-Reflow Phenomenon* / blood
  • No-Reflow Phenomenon* / immunology
  • Percutaneous Coronary Intervention*
  • Procalcitonin / blood
  • ROC Curve
  • Retrospective Studies
  • ST Elevation Myocardial Infarction* / blood
  • ST Elevation Myocardial Infarction* / immunology
  • ST Elevation Myocardial Infarction* / physiopathology
  • ST Elevation Myocardial Infarction* / surgery

Substances

  • C-Reactive Protein
  • Biomarkers
  • Procalcitonin