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      The Associations of Two Novel Inflammation Indexes, SII and SIRI with the Risks for Cardiovascular Diseases and All-Cause Mortality: A Ten-Year Follow-Up Study in 85,154 Individuals

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          Abstract

          Background

          SII and SIRI are two novel systemic inflammation indexes that were suggested in predicting poor outcomes in cancers. However, no studies have examined their effect on cardiovascular diseases (CVDs) and all-cause mortality. Thus, this study aims to investigate associations between SII, SIRI, and the risks for CVDs and all-cause mortality.

          Methods

          A total of 85,154 participants from the Kailuan cohort were included and followed up for incidents of CVDs (including MI, stroke) and all-cause death for 10 years. Multiple Cox regression was used to calculate the adjusted hazard ratios (HRs).

          Results

          During the follow-up period, 4262 stroke events, 1233 MI events, and 7225 all-cause deaths were identified, respectively. Compared with the lowest quantile (Q1) of SII or SIRI, after adjusted for most cardiovascular risk factors, both indexes showed positive associations with the risk for stroke (adjusted HRs in Q4 were 1.264 (95% CI: 1.157,1.382) for SII, 1.194 (95% CI: 1.087,1.313) for SIRI), and all-cause death (adjusted HRs in Q4 were 1.246 (95% CI: 1.165,1.331) for SII, 1.393 (95% CI: 1.296,1.498) for SIRI). Additionally, higher SII and SIRI are also associated with increased risk of hemorrhagic stroke and ischemic stroke. Higher SIRI but not SII exhibited a higher MI risk, the adjusted HR in Q4 was 1.204 (1.013,1.431). The significant association remained after additional adjustment for CRP. Subgroup analysis and sensitivity analysis displayed consistent results except for SIRI with MI, where the association did not arrive at significance in subjects aged ≥60.

          Conclusion

          Elevated SII and SIRI increased the risk of stroke, two stroke subtypes, and all-cause death. Higher SIRI, but not SII associated with increased MI incidence, and the association of SIRI was only significant in subjects aged <60.

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          Most cited references45

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          Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study

          Global estimates of the effect of common modifiable risk factors on cardiovascular disease and mortality are largely based on data from separate studies, using different methodologies. The Prospective Urban Rural Epidemiology (PURE) study overcomes these limitations by using similar methods to prospectively measure the effect of modifiable risk factors on cardiovascular disease and mortality across 21 countries (spanning five continents) grouped by different economic levels.
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            Systemic immune-inflammation index for predicting prognosis of colorectal cancer

            AIM To investigate the clinical significance of preoperative systemic immune-inflammation index (SII) in patients with colorectal cancer (CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with CRC. RESULTS The optimal cut-off point for SII was defined as 340. The overall survival (OS) and disease-free survival (DFS) were better in patients with low NLR, PLR, and SII (P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics (ROC) curve for SII (0.707) was larger than those for NLR (0.602) and PLR (0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.
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              Neutrophil to lymphocyte ratio and cardiovascular diseases: a review.

              The role of inflammatory markers in cardiovascular diseases has been studied extensively and a consistent relationship between various inflammatory markers and cardiovascular diseases has been established in the past. Neutrophil to lymphocyte ratio (NLR) is a new addition to the long list of these inflammatory markers. NLR, which is calculated from complete blood count with differential, is an inexpensive, easy to obtain, widely available marker of inflammation, which can aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers. It has been associated with arterial stiffness and high coronary calcium score, which are themselves significant markers of cardiovascular disease. NLR is reported as an independent predictor of outcome in stable coronary artery disease, as well as a predictor of short- and long-term mortality in patients with acute coronary syndromes. It is linked with increased risk of ventricular arrhythmias during percutaneous coronary intervention (PCI) and higher long-term mortality in patients undergoing PCI irrespective of indications of PCI. In patients admitted with advanced heart failure, high NLR was reported with higher inpatient mortality. Recently, NLR has been reported as a prognostic marker for outcome from coronary artery bypass grafting and postcoronary artery bypass grafting atrial fibrillation.
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                Author and article information

                Journal
                J Inflamm Res
                J Inflamm Res
                jir
                jinres
                Journal of Inflammation Research
                Dove
                1178-7031
                18 January 2021
                2021
                : 14
                : 131-140
                Affiliations
                [1 ]Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University , Hangzhou 310058, Zhejiang, People’s Republic of China
                [2 ]Health Care Center, Kailuan Group , Tangshan 063000, People’s Republic of China
                [3 ]Department of Intensive Medicine, Kailuan General Hospital , Tangshan 063000, People’s Republic of China
                [4 ]Hangzhou Center for Disease Control and Prevention , Hangzhou 310051, Zhejiang, People’s Republic of China
                [5 ]Department of Respiratory Diseases, Sir Run Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University , Hangzhou, Zhejiang 310060, People’s Republic of China
                [6 ]Department of Pathology, School of Medicine, Zhejiang University , Hangzhou 310058, Zhejiang, People’s Republic of China
                [7 ]Department of Cardiology, Kailuan General Hospital , Tangshan, 063000, People’s Republic of China
                Author notes
                Correspondence: Shouling Wu Department of Cardiology, Kailuan General Hospital , 57 Xinhua East Road, Tangshan, People’s Republic of China Email drwusl@163.com
                Yimin Zhu Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University , 388 Yu-Hang-Tang Road, Hangzhou, 310058Zhejiang, People’s Republic of ChinaTel + 0086-571-88208194 Email zhuym@zju.edu.cn
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0001-7095-6022
                Article
                283835
                10.2147/JIR.S283835
                7822090
                33500649
                f5c7129f-4c21-4287-8974-f24298102377
                © 2021 Jin et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 24 September 2020
                : 31 December 2020
                Page count
                Figures: 2, Tables: 9, References: 45, Pages: 10
                Funding
                Funded by: National Key Research and Development Program of China;
                Funded by: Hangzhou Science and Technology Project;
                This work was supported by the grants from National Key Research and Development Program of China (2017YFC0907004) and Hangzhou Science and Technology Project (20171226Y27). The funders have no role in the design of the study, collection, analysis, and interpretation of data.
                Categories
                Original Research

                Immunology
                systemic inflammation,prospective study,risk factors,cardiovascular events,mortality
                Immunology
                systemic inflammation, prospective study, risk factors, cardiovascular events, mortality

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