Prognostic significance of inflammation in patients with coronary artery disease at low residual inflammatory risk

Tianyu Li; Peizhi Wang; Xiaozeng Wang; Zhenyu Liu; Zheng Zhang; Yongzhen Zhang; Zhifang Wang; Yingqing Feng; Qingsheng Wang; Xiaogang Guo; Xiaofang Tang; Jingjing Xu; Ying Song; Yan Chen; Na Xu; Yi Yao; Ru Liu; Pei Zhu; Yaling Han; Jinqing Yuan

doi:10.1016/j.isci.2023.108060

Prognostic significance of inflammation in patients with coronary artery disease at low residual inflammatory risk

iScience. 2023 Sep 28;26(11):108060. doi: 10.1016/j.isci.2023.108060. eCollection 2023 Nov 17.

Authors

Tianyu Li¹, Peizhi Wang¹, Xiaozeng Wang², Zhenyu Liu³, Zheng Zhang⁴, Yongzhen Zhang⁵, Zhifang Wang⁶, Yingqing Feng⁷, Qingsheng Wang⁸, Xiaogang Guo⁹, Xiaofang Tang¹⁰, Jingjing Xu¹⁰, Ying Song¹⁰, Yan Chen¹⁰, Na Xu¹⁰, Yi Yao¹⁰, Ru Liu¹⁰, Pei Zhu¹⁰, Yaling Han³, Jinqing Yuan^{1

10}

Affiliations

¹ National Clinical Research center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
² Cardiovascular Research Institute & Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China.
³ Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
⁴ Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou 730000, China.
⁵ Department of Cardiology, Peking University Third Hospital, Beijing 100191, China.
⁶ Department of Cardiology, Xinxiang Central Hospital, Xinxiang 453002, China.
⁷ Department of Cardiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
⁸ Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao 066000, China.
⁹ Department of Cardiology, The First Affiliated Hospital of Zhejiang University, Hangzhou 314400, China.
¹⁰ Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Abstract

Patients with coronary artery disease (CAD) at low residual inflammatory risk are often overlooked in research and practice. This study examined the associations between fourteen inflammatory indicators and all-cause mortality in 5,339 CAD patients with baseline high-sensitivity C-reactive protein (hsCRP) <2 mg/L who received percutaneous coronary intervention and statin and aspirin therapy. The median follow-up time was 2.1 years. Neutrophil-derived systemic inflammatory response index (SIRI) yielded the strongest and most robust association with all-cause mortality among all indicators. Lower hsCRP remained to be associated with a lower risk of all-cause mortality. A newly developed comprehensive inflammation score (CIS) showed better predictive performance than other indicators, which was validated by an independent external cohort. In conclusion, neutrophil-derived indicators, particularly SIRI, strongly predicted all-cause mortality independent of hsCRP in CAD patients at low residual inflammatory risk. CIS may help identify individuals with inflammation burdens that cannot be explained by hsCRP alone.

Keywords: Cardiovascular medicine; Death; Pathophysiology.