Abstract
Background and Objectives: Excessive coronary thrombus burden is known to cause an increase in mortality and major adverse cardiac events (MACEs) in NSTE-ACS (non-ST acute coronary syndrome) patients. We investigated the association between the systemic immune-inflammation index (SII) and coronary thrombus burden in patients with non-ST segment elevation myocardial infarction (NSTEMI) who underwent coronary angiography and percutaneous coronary intervention (PCI). Materials and Methods: A total of 389 patients with the diagnosis of NSTEMI participated in our study. Coronary thrombus burden was classified in the TIMI (thrombolysis in myocardial infarction) thrombus grade scale and patients were divided into two groups: a TIMI thrombus grade 0–1 group (n = 209, 157 males) and a TIMI thrombus grade 2–6 group (n = 180, 118 males). Demographics, angiographic lesion images, coronary thrombus burden, clinical risk factors, laboratory parameters, and SII score were compared between the two groups. Results: The high thrombus burden patient group had a higher neutrophil count, WBC count, platelet count, and systemic immune-inflammation index (SII) (p < 0.001). The receiver operating characteristic (ROC) curve analysis showed that at a cutoff of 1103, the value of SII manifested 74.4% sensitivity and 74.6% specificity for detecting a high coronary thrombus burden. Conclusions: Our study showed that the SII levels at hospital admission were independently associated with high coronary thrombus with NSTEMI.
Highlights
Coronary vessel wall inflammation-causing atherosclerosis and cardiovascular diseases (CVD) are the most common causes of mortality and account for approximately30% of all deaths [1]
non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed according to the European Society of Cardiology (ESC) criteria including acute chest discomfort, and a rise in myocardial necrosis biomarkers without permanent ST-segment elevation electrocardiography (ECG)
The cutoff level of systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR) in predicting the coronary thrombus burden was determined by performing a receiver operating characteristic curve (ROC) analysis
Summary
Coronary vessel wall inflammation-causing atherosclerosis and cardiovascular diseases (CVD) are the most common causes of mortality and account for approximately. The amount of coronary thrombosis depends on the actual thrombotic–thrombolytic equilibrium This equilibrium of thrombosis cascade exhibits a broad spectrum, varying from mural limited thrombus to vascular occlusive thrombus and massive thrombus burden is associated with a higher incidence of periprocedural thrombotic complications and unsuccessful reperfusion. Especially in this patient group, we need biomarkers to show that the stability of the lesion may deteriorate due to the thrombus load and that will guide us for earlier invasive intervention or pretreatment with P2Y12 receptor inhibitors for the limitation of thrombus formation. We researched the function of the SII in estimating the risk of excessive coronary thrombosis formation in non-ST ACS (NSTE-ACS) patients who underwent coronary angiography (CAG)
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