Relationship Between Systemic Immune-Inflammation Index and No-Reflow in Percutaneous Coronary Intervention for Saphenous Grafts

Abstract

Objective: In this study, we investigated the occurrence of no-reflow (NR) in percutaneous coronary intervention (PCI) for saphenous vein grafts (SVGs) and its relationship with a new systemic immune-inflammation index (SII) that determines inflammation. Methods: We studied 303 patients with acute coronary syndrome without ST elevation who underwent PCI for SVG disease. Results: NR formation during SVG PCI was significantly higher in patients with high SII (p < 0.001). NR occurrence was 12.8% when SII was ≤548 and 41.9% when SII was >548. Conclusion: Our study is the first to investigate SII as the state of inflammation and its effect on the SVG PCI. Patients with higher SII have a higher risk of NR during an SVG for PCI.

Plain language summary

This study is about a type of surgery called bypass surgery, which is done to help when the heart is not working properly. During this surgery, doctors sometimes use veins in the leg to create new pathways for blood to flow around the heart. However, after a while these vessels can narrow or become blocked, so another procedure, stenting, is done to open them. Even after the stent is placed, the blood flow through the vein is sometimes not as good as it should be. This is called ‘no reflow’. We wanted to investigate how often this problem occurs and whether it is related to a marker called the systemic immune-inflammation index (SII), which is a measure of inflammation in the body.

We analyzed 303 patients who underwent stenting after a heart attack. We divided them into two groups according to their SII scores and investigated whether there was a difference in no-reflow occurrence between the two groups. We found that patients with a higher SII score were more likely to have no reflow during the stenting procedure, and an increased risk of no reflow if the SII score was above 548.

This study was the first to look at SII and how it affects the stenting procedure for vessels used in bypass surgery.

Keywords:

• acute coronary syndrome
• SII
• no-reflow
• percutaneous coronary intervention
• saphenous venous graft disease

Author contributions

Concept and design: G Demirci, A Şahin, T Aktemur and H Karakurt. Analysis and interpretation: G Demirci, A Demir, I Çetin, E Arslan and A Işık. Data collection: A Şahin, I Gürbak, and M Ertürk. Written by G Demirci and M Ertürk. Critical revision of the article: G Demirci, T Aktemur, I Çetin and H Karakurt. Final approval of the article: G Demirci, A Şahin, T Aktemur, A Demir, E Arslan, A Işık and myself Gürbak. Statistical analysis: G Demirci, A Şahin, T Aktemur, A Demir, E Arslan, A Işık and I Gürbak. General responsibility: G Demirci.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.