JCCVS

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

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Original Article
Role of Systemic Immune-Inflammation Index in predicting multi-territorial atherosclerotic disease in peripheral arterial disease: a retrospective cohort study
Aims: Death in patients with peripheral artery disease (PAD) is most often due to coronary artery disease (CAD) or cerebrovascular accidents (CVA). Systemic Immune-Inflammation Index (SII) can be used as a prognostic indicator in different cardiovascular diseases (CVD), including PAD. Our aim in this study was to investigate the predictive value of SII in detecting the coexistence of other CVD in patients with PAD.
Methods: The study included the results of 100 patients who were admitted to the cardiovascular surgery outpatient clinic of our hospital and diagnosed with PAD. PAD, CAD and carotid artery disease (CAAD) were diagnosed by history, physical examination, electrocardiography, duplex ultrasonography and ankle-brachial index (ABI) calculation. SII was determined as neutrophil count multiplied by platelet count and divided by lymphocyte count.
Results: 38 patients had CAAD, 28 had CAD, 19 had only PAD and 15 had all 3 diseases. Platelets levels (285±32.6 vs 234±9.6, p<0.001), Neutrophils levels (4.9±1.1 vs 4.1±9.8, p<0.001) and SII levels (4.9 ±1.1 vs 4.1±1.8, p<0.001) were compared in both groups with and without other arterial diseases in terms of laboratory findings, while other laboratory findings were not statistically different between both groups (p<0.05).
Conclusion: In our study, we found that those with CAD or CAAD had higher SII levels than those with only PAD.


1. Tanimoto S, Ikari Y, Tanabe K, et al. Prevalence of carotid artery stenosis in patients with coronary artery disease in Japanese population. Stroke. 2005;36(10):2094-2098. doi:10.1161/01.STR.0000185337.82019.9e
2. Kallikazaros I, Tsioufis C, Sideris S, Stefanadis C, Toutouzas P. Carotid artery disease as a marker for the presence of severe coronary artery disease in patients evaluated for chest pain. Stroke. 1999;30(5):1002-1007. doi:10.1161/01.str.30.5.1002
3. Steinvil A, Sadeh B, Arbel Y, et al. Prevalence and predictors of concomitant carotid and coronary artery atherosclerotic disease. J Am Coll Cardiol. 2011;57(7):779-783. doi:10.1016/j.jacc.2010.09.047
4. Qureshi AI, Alexandrov AV, Tegeler CH, et al. Guidelines for screening of extracranial carotid artery disease: a statement for healthcare professionals from the multidisciplinary practice guidelines committee of the American Society of Neuroimaging; cosponsored by the Society of Vascular and Interventional Neurology. J Neuroimaging. 2007;17(1): 19-47. doi:10.1111/j.1552-6569.2006.00085.x
5. Kurvers HA, van der Graaf Y, Blankensteijn JD, Visseren FLJ, Eikelboom BC, SMART Study Group. Screening for asymptomatic internal carotid artery stenosis and aneurysm of the abdominal aorta: comparing the yield between patients with manifest atherosclerosis and patients with risk factors for atherosclerosis only. J Vasc Surg. 2003; 37(6):1226-1233. doi:10.1016/s0741-5214(02)75140-9
6. Cheng SW, Wu LL, Lau H, Ting AC, Wong J. Prevalence of significant carotid stenosis in Chinese patients with peripheral and coronary artery disease. Aust N Z J Surg. 1999;69(1):44-47. doi:10.1046/j.1440-1622.1999. 01501.x
7. Ji Y, Wang H. Prognostic prediction of Systemic Immune-Inflammation Index for patients with gynecological and breast cancers: a meta-analysis. World J Surg Oncol. 2020;18(1):197. doi:10.1186/s12957-020-01974-w
8. Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of Systemic Immune-Inflammation Index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020;20:499. doi:10.1186/s12935-020-01590-4
9. Zhang Y, Lin S, Yang X, Wang R, Luo L. Prognostic value of pretreatment Systemic Immune-Inflammation Index in patients with gastrointestinal cancers. J Cell Physiol. 2019;234(5):5555-5563. doi:10. 1002/jcp.27373
10. Huang J, Zhang Q, Wang R, et al. Systemic Immune-Inflammatory Index predicts clinical outcomes for elderly patients with acute myocardial infarction receiving percutaneous coronary intervention. Med Sci Monit. 2019;25:9690-9701. doi:10.12659/MSM.919802
11. Yang YL, Wu CH, Hsu PF, et al. Systemic Immune-Inflammation Index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020;50(5):e13230. doi:10.1111/eci.13230
12. Huang T, Peng Q, Zhang Y, Zhu Z, Fan X. The Systemic Immune-Inflammation Index (SII) and coronary artery lesions in Kawasaki disease. Clin Exp Med. 2024;24(1):4. doi:10.1007/s10238-023-01265-0
13. Oflar E, Akdeniz E, Yıldız C, et al. Evaluation of systemic immune-inflammation index for predicting severity of lower extremity arterial disease. Vascular. 2024;32(4):797-803. doi:10.1177/17085381241251772
14. Decrinis M, Doder S, Stark G, Pilger E. A prospective evaluation of sensitivity and specificity of the ankle/brachial index in the follow-up of superficial femoral artery occlusions treated by angioplasty. Clin Investig. 1994;72(8):592-597. doi:10.1007/BF00227451
15. Rutherford RB, Baker JD, Ernst C, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg. 1997;26(3):517-538. doi:10.1016/s0741-5214(97)70045-4
16. Scalise E, Costa D, Gallelli G, et al. Biomarkers and social determinants in atherosclerotic arterial diseases: a scoping review. Ann Vasc Surg. 2025;113:41-63. doi:10.1016/j.avsg.2024.12.076
17. Khan H, Girdharry NR, Massin SZ, et al. Current prognostic biomarkers for peripheral arterial disease: a comprehensive systematic review of the literature. Metabolites. 2025;15(4):224. doi:10.3390/metabo15040224
18. Gersh BJ, Rihal CS, Rooke TW, Ballard DJ. Evaluation and management of patients with both peripheral vascular and coronary artery disease. J Am Coll Cardiol. 1991;18(1):203-214. doi:10.1016/s0735-1097(10)80241-4
19. Barzilay JI, Kronmal RA, Bittner V, Eaker E, Foster ED. Coronary artery disease in diabetic and nondiabetic patients with lower extremity arterial disease: a report from the Coronary Artery Surgery Study Registry. Am Heart J. 1998;135(6 Pt 1):1055-1062. doi:10.1016/s0002-8703(98)70072-9
20. Mautner SL, Mautner GC, Hunsberger SA, Roberts WC. Comparison of composition of atherosclerotic plaques in saphenous veins used as aortocoronary bypass conduits with plaques in native coronary arteries in the same men. Am J Cardiol. 1992;70(18):1380-1387. doi:10.1016/ 0002-9149(92)90285-7
21. Murabito JM, Evans JC, Larson MG, et al. The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death: the Framingham Study. Arch Intern Med. 2003;163(16):1939-1942. doi:10. 1001/archinte.163.16.1939
22. Brevetti G, Piscione F, Silvestro A, et al. Increased inflammatory status and higher prevalence of three-vessel coronary artery disease in patients with concomitant coronary and peripheral atherosclerosis. Thromb Haemost. 2003;89(6):1058-1063.
23. Erren M, Reinecke H, Junker R, et al. Systemic inflammatory parameters in patients with atherosclerosis of the coronary and peripheral arteries. Arterioscler Thromb Vasc Biol. 1999;19(10):2355-2363. doi:10.1161/01.atv.19.10.2355
24. Rossi A, Franceschini L, Fusaro M, et al. Carotid atherosclerotic plaque instability in patients with acute myocardial infarction. Int J Cardiol. 2006;111(2):263-266. doi:10.1016/j.ijcard.2005.08.030
25. Vidakovic R, Schouten O, Kuiper R, et al. The prevalence of polyvascular disease in patients referred for peripheral arterial disease. Eur J Vasc Endovasc Surg. 2009;38(4):435-440. doi:10.1016/j.ejvs.2009.05.006
26. Amrock SM, Weitzman M. Multiple biomarkers for mortality prediction in peripheral arterial disease. Vasc Med. 2016;21(2):105-112. doi:10.1177/1358863X15621797
27. Haumer M, Amighi J, Exner M, et al. Association of neutrophils and future cardiovascular events in patients with peripheral artery disease. J Vasc Surg. 2005;41(4):610-617. doi:10.1016/j.jvs.2005.01.013
28. Aykan A&Ccedil;, Hatem E, Kalaycıoğlu E, et al. Neutrophil-to-lymphocyte ratio may be a marker of peripheral artery disease complexity. Anatol J Cardiol. 2016;16(7):497-503. doi:10.5152/AnatolJCardiol.2015.6240
29. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013; 11(1):55-59. doi:10.1586/erc.12.159
30. Songur M, Simsek E, Faruk O, Kavasoglu K, Alagha S, Karahan M. The platelet-lymphocyte ratio predict the risk of amputation in critical limb ischemia. J Vasc Med Surg. 2014;02(04):158. doi:10.4172/2329-6925. 1000158
31. Yalım Z, Aldemir M, Emren SV. Association of inflammatory markers with multisite artery disease in patients with peripheral arterial disease. Clin Investig Arterioscler. 2021;33(2):55-61. doi:10.1016/j.arteri.2020.08.002
32. Zhang L, Xu X, Zhang X, Jiang S, Hui P. Systemic Immune-Inflammation Index is associated with ulcerative plaque in patients with acute ischemic stroke: a single center exploratory study. J Clin Ultrasound. 2024;52(3):295-304. doi:10.1002/jcu.23632
33. Aktemur T, Demirci G, Tasbulak O, et al. A simple predictor for long-term mortality after percutaneous iliac artery intervention: Systemic Immune Inflammatory Index. Ann Vasc Surg. 2023;96:276-283. doi:10. 1016/j.avsg.2023.03.012
34. Kelesoglu S, Yilmaz Y, Elcik D, et al. Increased serum Systemic Immune-Inflammation Index is independently associated with severity of carotid artery stenosis. Angiology. 2023;74(8):790-797. doi:10.1177/ 00033197221144934
35. Candemir M, Kiziltun&ccedil; E, Nurko&ccedil; S, Şahinarslan A. Relationship between Systemic Immune-Inflammation Index (SII) and the severity of stable coronary artery disease. Angiology. 2021;72(6):575-581. doi:10. 1177/0003319720987743
36. Balta S, Celik T, Mikhailidis DP, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clin Appl Thromb Hemost. 2016;22(5):405-411. doi:10.1177/1076029615569568
37. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999; 340(2):115-126. doi:10.1056/NEJM199901143400207
38. N&uacute;&ntilde;ez J, Sanchis J, Bod&iacute; V, et al. Relationship between low lymphocyte count and major cardiac events in patients with acute chest pain, a non-diagnostic electrocardiogram and normal troponin levels. Atherosclerosis. 2009;206(1):251-257. doi:10.1016/j.atherosclerosis.2009. 01.029
39. Li N. Platelet-lymphocyte cross-talk. J Leukoc Biol. 2008;83(5):1069-1078. doi:10.1189/jlb.0907615
40. Demirtas S, Karahan O, Yazici S, et al. The relationship between complete blood count parameters and Fontaine&rsquo;s Stages in patients with peripheral arterial disease. Vascular. 2014;22(6):427-431. doi:10.1177/ 1708538114522227
41. Duran M, Gunebakmaz O, Uysal OK, et al. Relation between mean platelet volume and coronary collateral vessels in patients with acute coronary syndromes. J Cardiol. 2013;61(4):295-298. doi:10.1016/j.jjcc. 2012.12.011
Volume 3, Issue 2, 2025
Page : 35-39
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