The Predictive Role of Systemic Inflammation Response Index (SIRI) in the Prognosis of Stroke Patients.

Objective: To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease. Methods: In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed. Results: There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) (P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased (P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased (P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group (P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis (P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection (P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95%CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion: The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

Is to assess the diagnostic and prognostic role of different inflammatory indices in patients with benign and malignant thyroid nodules. The neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), derived NLR (dNLR), systemic inflammation index (SII), neutrophil to lymphocyte, platelet ratio (NLPR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were assessed in150 thyroid cancer (TC) patients, 75 benign nodule patients, compared to 70 healthy controls. There was a significant difference among TC patients and control group regarding the PLR, LMR, SII, NLPR, SIRI, and AISI (p = 0.006, p < 0.001, p = 0.043,p < 0.001 p < 0.001, and p < 0.001; respectively). LMR and SIRI could efficiently differentiate malignant versus benign thyroid nodules at a cutoff of 5.2 and 0.597; respectively. LMR, PLR, SIRI, and AISI were notably associated with high-risk stratification of TC patients (p = 0.011, p = 0.035, p = 0.036, and p = 0.034; respectively). Moreover, PLR was significantly elevated in TC patients with lymph node (LN) metastasis (p = 0.010). The LMR (OR = 0.318, p < 0.001), SIRI (OR = 2.293, p = 0.001), AISI (OR = 2.714, p < 0.001), and FT4 (OR = 0.250, p < 0.001) could differentiate TC against non-TC groups. LMR, SIRI, AISI, and FT4 are independent risk factors for TC (p < 0.001, p = 0.030, p = 0.026, and p < 0.001; respectively). There was no significant impact of the assessed inflammatory indices on the disease-free survival of the patients. LMR, PLR, SII, NLPR, SIRI, and AISI could be potential supportive markers for TC diagnosis. LMR and SIRI could help in differentiating malignant versus benign thyroid nodules.

The aim of this study was to explore the relationship between functional prognosis and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic inflammatory response index (SIRI) in patients with acute ischemic stroke (AIS) at discharge. A total of 861 patients with AIS were enrolled between January 2019 and December 2021. Blood cell counts were collected on admission. Logistic regression analysis was performed to assess the relationship between NLR, PLR, LMR, SIRI and adverse functional outcomes (modified Rankin scale score of 3-6) at discharge. We also used receiver operating characteristic (ROC) curves to estimate the overall ability of NLR, PLR, LMR and SIRI to judge short-term functional outcomes. Associations between NLR, PLR, LMR, and SIRI with length of hospital stay were analyzed by Spearman correlation test. A total of 194 patients (22.5%) had poor functional outcomes at discharge. Multivariate logistic regression analysis showed that NLR (odds ratio [OR], 1.060; 95% confidence interval [CI] 1.004-1.120, P=0.037), PLR (OR, 1.003; 95% CI 1.000-1.005, P=0.018), LMR (OR, 0.872; 95% CI 0.774-0.981, P=0.023) and SIRI (OR, 1.099; 95% CI 1.020-1.184, P=0.013) were independent factors for poor functional outcome. The odds ratios of the highest versus lowest quartiles of NLR, PLR and SIRI were 2.495 (95% CI 1.394-4.466), 1.959 (95% CI 1.138-3.373) and 1.866 (95% CI 1.106-3.146), respectively. The odds ratio of the lowest versus highest quartile of LMR was 2.300 (95% CI 1.331-3.975). The areas under the curve (AUCs) of the NLR, PLR, LMR, and SIRI to discriminate poor functional prognosis were 0.644, 0.587, 0.628, and 0.651, respectively. NLR, LMR, and SIRI were related with the length of hospital stay (P<0.05). NLR, PLR, LMR, and SIRI were associated with functional outcome at discharge in AIS patients. NLR, LMR and SIRI were related to hospitalization days in patients with AIS.

Immunoinflammatory response can participate in the development of cancer. To investigate the relationship between pretreatment systemic immune inflammatory response index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and lymph node metastasis in patients with papillary thyroid carcinoma (PTC). A retrospective analysis was performed on 547 PTC patients treated in Meizhou People's Hospital from January 2018 to December 2021. Clinicopathological data were collected, including gender, age, Hashimoto's thyroiditis, maximum tumor diameter, extra-membrane infiltration, disease stage, BRAF V600E mutation, pretreatment inflammatory index levels, and lymph node metastasis. The optimal cutoff values of SII, SIRI, NLR, PLR and LMR were calculated by receiver operating characteristic (ROC) curve, and the relationship between inflammatory indexes and other clinicopathological features and lymph node metastasis was analyzed. There were 303 (55.4%) PTC patients with lymph node metastasis. The levels of SII, SIRI, NLR, and PLR in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis, while the levels of LMR were significantly lower than those in patients without lymph node metastasis (all p<0.05). When lymph node metastasis was taken as the endpoint, the critical value of SII was 625.375, the SIRI cutoff value was 0.705, the NLR cutoff value was 1.915 (all area under the ROC curve >0.6). The results of regression logistic analysis showed that age <55 years old (OR: 1.626, 95% CI: 1.009-2.623, p=0.046), maximum tumor diameter >1cm (OR: 2.681, 95% CI: 1.819-3.952, p<0.001), BRAF V600E mutation (OR: 2.709, 95% CI: 1.542-4.759, p=0.001), SII positive (≥625.375/<625.375, OR: 2.663, 95% CI: 1.560-4.546, p<0.001), and NLR positive (≥1.915/<1.915, OR: 1.808, 95% CI: 1.118-2.923, p=0.016) were independent risk factors for lymph node metastasis of PTC. Age <55 years old, maximum tumor diameter >1cm, BRAF V600E mutation, SII positive, and NLR positive were independent risk factors for lymph node metastasis in PTC.

We investigated the relationship between inflammatory indicators derived from complete blood cell (CBC) counts and all-cause mortality in individuals with rheumatoid arthritis (RA). Data were collected from the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2018, with a median follow-up duration of 78 months. The inflammatory indicators derived from CBC included several types: the systemic inflammatory response index (SIRI), the systemic immune-inflammation index (SII), the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the monocyte-to-lymphocyte ratio (MLR). The multiple COX regression models were used to estimate adjusted hazard ratios (HRs) and 95% CIs concerning all-cause mortality of participants with RA, which focused on CBC-derived inflammatory indicators. Additionally, restricted cubic spline (RCS) curve was utilized to investigate non-linear associations. The research comprised a cohort of 1,314 individuals, among whom 246 with RA succumbed during a median follow-up duration of 78 months. After adjusting for key covariates, the mortality rate in patients with RA who had high SIRI, NLR, and MLR levels was considerably higher than in those with medium or low SIRI, NLR, and MLR levels. Compared with the lowest tertile, the highest tertiles of SIRI (HR 1.87, 95% CI: 1.12-3.13), NLR (HR 1.79, 95% CI: 1.10-2.92), and MLR (HR 1.88, 95% CI: 1.17-3.02) were associated with an increased risk of all-cause mortality. The Kaplan-Meier analysis indicated a significant decrease in the survival probability among individuals with elevated SIRI, NLR, and MLR levels. The RCS analysis revealed a linear association between SIRI, NLR, MLR, and RA-related all-cause mortality, whereas a non-linear relationship was identified between the SII, PLR, and mortality. This investigation revealed that the SIRI, NLR, and MLR are novel, valuable, and convenient inflammatory indicators. In the United States adults with RA, higher SIRI, NLR, and MLR were independently associated with an increased long-term mortality risk. These findings not only assist in uncovering the potential utility of predicting RA outcomes but also provide rheumatologists valuable guidance for disease management.

The Pretreatment Systemic Inflammation Response Index as a Useful Prognostic Factor is Better Than Lymphocyte to Monocyte Ratio in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Objectives:To uncover the predictive value of systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI) on early pregnancy loss.Methods:A total of 535 individuals were enrolled in this retrospective analysis. The early pregnancy losses (EPL) group included patients between 18-35 years old who experienced EPL. The control group comprised healthy pregnant women who gave birth at ≥37 weeks.Results:The EPL group had significantly lower plateletcrit (p=0.04), platelet distribution width (PDW, p<0.0001), and RDW (p<0.0001) and higher monocyte (p<0.0001) and SIRI (p<0.0001) values than the control group. The hemoglobin, white blood cells, platelet count, neutrophil count, lymphocyte count, mean platelet volume, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and SII values were not significantly different between the EPL and control groups (p>0.05). The cut-off value for the SIRI that offers the best sensitivity/specificity balance was 1.48 (sensitivity of 63%; specificity of 63%) in the receiver operating characteristics curve. Among the inflammatory parameters for predicting EPL, PDW had highest specificity (84%), and RDW had the highest sensitivity (80%).Conclusion:This study provides compelling evidence that various inflammatory pathways may significantly contribute to EPL pathogenesis. Moreover, our findings suggest that SIRI could be a more effective marker than NLR, PLR, MLR, and SII in predicting EPL in an ongoing pregnancy, thereby potentially revolutionizing early pregnancy loss diagnostics.

BackgroundCardiovascular-kidney-metabolic (CKM) syndrome is a major public health concern associated with increased mortality. Inflammation plays a critical role in CKM progression and outcomes. This study investigates the relationship between inflammatory indices and mortality risk in CKM patients.MethodsA comprehensive analysis of data from 26,265 participants in the National Health and Nutrition Examination Survey (NHANES) database (2007–2016) with CKM syndrome stages 0–4 was conducted. The primary outcomes of the study were all-cause and cardiovascular mortality. The inflammatory indices encompassed the systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI), and neutrophil-to-albumin ratio (NAR). Multivariable Cox models, adjusted for demographic and clinical confounders, were employed to examine nonlinearity, alongside restricted cubic splines and threshold analyses. The present study sought to compare the prognostic accuracy of the time-dependent ROC (Receiver Operating Characteristic) at 93 months.ResultsDuring a median follow-up of 93.4 months, 2,292 subjects experienced all-cause mortality and 701 experienced cardiovascular deaths. In the adjusted models, elevated SIRI (all-cause HR 1.11, 95% CI 1.06–1.15; cardiovascular HR 1.18, 1.10–1.27), NLR (all-cause HR 1.08, 1.05–1.12; cardiovascular HR 1.11, 1.05–1.17) and MLR (all-cause HR 2.27, 1.71–3.01; cardiovascular HR 3.37, 2.09–5.44) were independently associated with mortality (all p < 0.0001). Dose–response analyses revealed nonlinear J-shaped relationships: MLR showed marked risk above 0.19 (HR 2.59), NLR risk was greatest below 3 (HR 1.14), and SIRI thresholds differed for all-cause (> 1.74, HR 1.09) versus cardiovascular (> 0.38, HR 1.17) outcomes. At 93 months, MLR demonstrated the highest discriminatory ability (AUC 0.630; C-index 0.667; p < 0.001), outperforming SIRI (AUC 0.611) and NLR (AUC 0.602). PLR, AISI, SII and NAR showed limited predictive value due to imbalanced sensitivity–specificity. The impact of age and the early stages of CKD on the modification of associations was investigated.ConclusionSystemic inflammatory indices demonstrated nonlinear, J-shaped associations with mortality in CKM syndrome, with the MLR showing the strongest association across disease trajectories. MLR, NLR, and SIRI were identified as potential risk indicators, with stronger associations observed in younger patients and those with early-stage CKM syndrome.HighlightsSystemic inflammatory markers (SIRI, NLR, MLR) were significantly associated with increased mortality risk in CKM syndrome.Most inflammation indices exhibited nonlinear, J-shaped associations with mortality.Nonlinear threshold analyses identified specific risk inflection points for SIRI, NLR, and MLR.These associations were stronger in younger patients (≤ 60 years) and those with early CKM stages (1–2).Supplementary InformationThe online version contains supplementary material available at 10.1007/s12026-025-09707-5.

ObjectiveThis investigation intends to clarify the disparities in hematological parameters and ratios among different age groups,providing new insights for the diagnostic of Mycobacterium Avium Complex Pulmonary Disease (MAC-PD).Patients and MethodsA retrospective investigation was undertaken to examine the hematological parameters of elderly (n=88) and non-elderly (n=44) patients diagnosed with MAC-PD at Hebei Chest Hospital between 2020 and 2024. The study involved the calculation of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), hemoglobin-to-lymphocyte ratio (HLR),hemoglobin-to-platelet ratio (HPR),systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII). Statistical analyses were executed utilizing SPSS 27.0 and R (4.2.1) software.ResultsThe levels of absolute lymphocyte count (ALC),hemoglobin (Hb) and LMR were lower in Elderly MAC group compared to Non-elderly MAC group. Conversely,the levels of NLR, PLR,HLR,SIRI and SII were higher in Elderly MAC group than in Non-elderly MAC group. There was a certain correlation between the Ct value of MAC nucleic acid and NLR, LMR, SIRI and SII (P<0.05) in Elderly MAC group. In Non-elderly MAC group, the Ct value of MAC nucleic acid was correlated with absolute neutrophil count (ANC), LMR, SIRI and SII (P<0.05). Receiver operating characteristic curve (ROC) analysis indicated that NLR, LMR, SIRI and SII exhibited high diagnostic value in Elderly MAC group,while LMR, SIRI and SII demonstrated high diagnostic value in Non-elderly MAC group. The combined diagnostic value was even more prominent. Nevertheless,no significant diagnostic indicators were identified between Elderly MAC group and Non-elderly MAC group.ConclusionThe combination of NLR, LMR, SIRI and SII may serve as diagnostic markers for Elderly MAC-PD and the combination of LMR, SIRI and SII may serve as diagnostic markers for Non-lderly MAC-PD. But there were no significant diagnostic indicators differentiating Elderly MAC group from Non-elderly MAC group.

Stroke is the second leading cause of death worldwide, and China has the highest stroke incidence in the world. The systemic inflammatory response index (SIRI), systemic inflammatory response index (SIRI), systemic immune-inflammatory index (SII), neutrophil-to-high-density lipoprotein ratio (NHR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) have clinical in predicting the prognosis of acute ischaemic stroke (AIS) patients. No studies have compared the predictive value of these six composite inflammatory markers. This study included 516 AIS patients with AIS symptoms for < 24 h. The short-term prognosis of AIS patients at 30 days was assessed using the modified Rankin scale (mRS), an mRS score > 2 defining poor prognosis. The results of the univariate analysis showed that all six composite inflammatory indices, SIRI, SII, NHR, NLR, PLR and MLR, were associated with a poor prognosis in patients with AIS. All six composite inflammatory indicators correlated with the short-term prognosis of AIS patients. The six composite inflammation indicators were included in the binary logistic regression, and the results showed that SIRI, NLR and PLR were found to be independent risk factors for poor short-term prognosis in AIS patients. Among the six inflammatory markers, SIRI, NLR and PLR were the most clinically valuable for predicting the short-term prognosis of patients with AIS. Peripheral blood indices are easy to obtain clinically and can provide important clinical value for early prognosis and treatment adjustment.

Objective: To discuss and analyze the effects of routine therapy combined with fenethisterone on serum systemic immune inflammation index (SII), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), neutrophil to high density lipoprotein ratio io, NHR) and Systemic Inflammation Response Index (SIRI). Methods: 60 patients with type 2 diabetes nephropathy admitted to our hospital from April to August 2020 were studied, including 20 patients with normal urinary protein, 20 patients with microalbuminuria and 20 patients with massive proteinuria. Patients with different proteinuria conditions were randomly divided into a control group and an experimental group, with 10 cases in each group. The control group received conventional therapy, while the experimental group received combined treatment with non nifedipine. Analyze and compare the changes in SII, PLR, NLR, MLR, NHR, and SIRI indicators between two groups of patients after intervention. Results: The serum SII, PLR, NLR, MLR, NHR, SIRI in patients with type 2 diabetes nephropathy with normal urinary protein, microalbumin and large proteinuria who were treated with fenelidone were significantly reduced, p &lt; 0.05, The difference is significant. Conclusion: The combination of conventional therapy and fenelidone can effectively improve the immune function of patients with type 2 diabetes nephropathy and reduce the inflammatory reaction of the body. It is an effective therapeutic drug and can be used in such patients.

The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammatory index (SII), systemic inflammation response index (SIRI), and Onodera's prognostic nutritional index (OPNI) have been reported as prognostic markers for various cancers. We evaluated the prognostic value of the NLR, PLR, MLR, SII, SIRI, and OPNI for poorly-to moderately-differentiated cervical squamous cell carcinoma (CSCC). We retrospectively analyzed the cases of 109 patients with early-stage poorly-to moderately-differentiated CSCC who underwent radical surgery at our institution in 2014-2017. The optimal cutoff points for the NLR, PLR, MLR, SII, SIRI, and OPNI were determined by receiver operating characteristic curves. Overall survival was analyzed by the Kaplan-Meier method. We performed a multivariate analysis using the Cox proportional hazard regression model to determine the independent prognostic indicators for early-stage poorly-to moderately-differentiated CSCC. The appropriate cutoff points were: NLR, 1.72; PLR, 111.96; MLR, .24; SII, 566.23; SIRI, 1.38; and OPNI, 52.68. The OS of the patients with a high OPNI (P = .04), low SII (P = .03), or low SIRI (P = .01) was significantly better. The uni- and multivariate analyses identified only the OPNI as an independent prognostic marker for early-stage poorly-to moderately-differentiated CSCC (P = .04 and P = .02). The OPNI is an independent prognostic marker for early-stage poorly-to moderately-differentiated CSCC; the NLR, PLR, MLR, SII, and SIRI are not.

To explore inflammation markers of C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI) in the differential diagnosis of cavitary pulmonary tuberculosis (PTB) from non-cavitary PTB. This retrospective study included 1233 patients with PTB, 518 patients were diagnosed with cavitary PTB as case group, while 715 patients which diagnosed with non-cavitary PTB were selected as control group. The clinical data of patients was collected and the levels of inflammation indices were measured. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnosis and analysis of selected indices. Logistic regression analysis was performed to evaluate the factors associated with cavitary PTB. The CRP, NLR, MLR, PLR, SII, and SIRI in the case group were significantly higher than those in the controls (all p<0.001). When cavitary PTB was taken as the endpoint, the optimal diagnostic thresholds of CRP was 35.365 (area under the ROC curve (AUC)=0.601), NLR was 5.740 (AUC=0.595), MLR was 0.525 (AUC=0.577), PLR was 198.255 (AUC=0.602), SII was 1252.045 (AUC=0.628), and SIRI was 2.095 (AUC=0.605), respectively. Logistic regression analysis showed that gender, CRP, PLR, and SIRI were the independent risk factors for cavitary PTB. The sensitivity of the combination of the three indices (CRP+PLR, CRP+SIRI, PLR+SIRI, and CRP+PLR+SIRI) were higher than those of the CRP, PLR, and SIRI. CRP, PLR, and SIRI levels were associated with an increased likelihood of cavitary PTB. The combined detection of CRP, PLR, and SIRI is promising as a screening marker and may be useful for ruling out PTB with cavitary.

Introduction The inflammatory response following an Acute Myocardial Infarction (AMI) has been extensively studied in recent years and plays a crucial role in post-infarction outcomes. Inflammation contributes to infarct size expansion, is directly linked to ischemia-reperfusion injury, and can lead to adverse left ventricular remodelling, resulting in a larger infarct size and worse prognosis. Therefore, quantifying inflammation may serve as an important prognostic marker in AMI patients. Objective The INFINITY study (INFlammatIoN amI sTudY) investigates the role of selected inflammatory biomarkers in predicting long-term outcomes after AMI. This sub-study evaluates the prognostic value of five inflammatory indexes: Systemic Immune Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Inflammation Response Index (SIRI). The study focuses on their association with short-term (in-hospital, M0) and long-term (1-month, M1 and 6-month, M6) Major Adverse Cardiovascular Events (MACEs), including cardiac death, non-fatal MI, unplanned revascularization, development of heart failure, angina or recurrent ACS requiring rehospitalization, and major bleeding. Methods A total of 103 patients with AMI (67 STEMI, 36 NSTEMI) were included in the study. Statistical analysis was performed using Cox proportional hazards models to assess the relationship between inflammatory indexes and clinical endpoints. The models were adjusted for age, sex, comorbidities, infarct size, and treatment strategy to account for potential confounders. Results The inflammatory indices SII, NLR, LMR, PLR, and SIRI showed a significant association with MACEs at 6 months. SII was strongly associated with MACEs both in-hospital (M0: p = 0.013) and at 1 month (M1: p = 0.007). SIRI and NLR demonstrated high predictive value for post-infarction MACEs (M1: p = 0.049, p = 0.020, respectively). LMR appeared to have a protective role, as higher values were associated with a lower risk of MACEs (M0: p = 0.234, M1: p = 0.106, M6: p = 0.236). PLR had moderate diagnostic value (M0: p = 0.080, M1: p = 0.024, M6: p = 0.306) but was influenced by other clinical factors. Cox regression models confirmed that SII and SIRI are independent predictors of MACEs, whereas LMR may act as a protective factor. Conclusions Inflammatory markers SII, NLR, SIRI, LMR, and PLR appear to have prognostic significance in AMI patients. Among them, SII and SIRI demonstrated the strongest association with major adverse cardiovascular events (MACEs) and heart failure development. Conversely, LMR may play a protective role. These inflammatory indexes could contribute to improved risk stratification and personalized post-infarction patient monitoring.Table 1 Figure 1

Inflammation is recognized as a critical component in the pathogenesis of lower extremity peripheral arterial disease (PAD); however, the association between novel immune-inflammatory biomarkers - neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI) - and PAD risk in the general population remains unexplored. This study examines the associations between PAD and NLR, PLR, MLR, SII, SIRI, and AISI. This study was a cross-sectional observational study based on the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. PAD was diagnosed using an Ankle-Brachial Index (ABI) ≤0.9. Finally, 6314 participants aged ≥40 years with complete information about ABI, blood cell counts, and other covariates were analyzed. Logistic regression analysis was used to examine the associations between inflammatory biomarkers and PAD. The predictive ability of inflammatory biomarkers for PAD was compared using receiver operating characteristic (ROC) curves. Subsequent mediation analysis examined the indirect effects of immune-inflammatory biomarkers on PAD via estimated glomerular filtration rate (eGFR). Finally, we performed propensity score matching (PSM) between PAD and non-PAD participants to verify the robustness of results. In 6314 US adults aged ≥40 years, 548 were diagnosed with PAD. Significant associations were observed between PAD and NLR (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 1.01-1.04), MLR (OR: 1.02; 95% CI: 1.00-1.04), SII (OR: 1.02; 95% CI: 1.00-1.03), SIRI (OR: 1.03; 95% CI: 1.01-1.04), and AISI (OR: 1.02; 95% CI: 1.01-1.03), according to logistic regression. PSM further validated the robustness of primary results. Mediation analysis revealed eGFR mediated portions of the relationship between PAD and NLR, MLR and SIRI (4.69%, 7.11% and 3.69% respectively). Additionally, ROC showed that SIRI exhibited a greater identification of PAD compared with other immune-inflammatory biomarkers. NLR, MLR, SII, SIRI, and AISI demonstrated independent associations with PAD risk, with SIRI showing a stronger association with PAD.