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已发表论文
系统免疫炎症指数在预测射血分数保留型心力衰竭患者心血管结局方面优于传统炎症标志物
Authors Zhu S, Li H, Ou Z, Zheng M, Yuan W
Received 25 September 2025
Accepted for publication 27 December 2025
Published 21 January 2026 Volume 2026:19 568473
DOI https://doi.org/10.2147/JIR.S568473
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Prof. Dr. Chengming Fan
Shijie Zhu,1 Haiying Li,2 Zipeng Ou,3 Muhan Zheng,4 Woliang Yuan1,2
1Department of Cardiovascular Medicine, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, People’s Republic of China; 2Department of Cardiovascular Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 3Department of Cardiovascular Medicine, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People’s Republic of China; 4Department of Rheumatology and Immunology, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, People’s Republic of China
Correspondence: Woliang Yuan, Email Ywoliang2022@163.com Muhan Zheng, Email 1078668399@qq.com
Background: The systemic immune-inflammation index (SII), a novel inflammatory index integrating neutrophil, platelet, and lymphocyte counts, predicts outcomes in several cardiovascular diseases, yet its role in heart failure with preserved ejection fraction (HFpEF) remains unclear. We therefore investigated the prognostic value of SII in HFpEF patients and compares its performance against other inflammatory markers, including systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP).
Methods: We retrospectively analyzed a cohort of 316 patients with HFpEF diagnosed between January 2017 and January 2021. All-cause mortality, cardiovascular mortality and HF rehospitalization were assessed over a median follow-up of 24 months. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were employed to evaluate the comparative prognostic performance of SII against SIRI, NLR and CRP.
Results: Logistic regression models revealed that each 100-unit increase in SII was independently associated with elevated risks of cardiovascular mortality (OR:1.321, 95% CI:1.191– 1.467, P< 0.001) and HF rehospitalization (OR:1.168, 95% CI:1.098– 1.241, P< 0.001), but not with all-cause mortality (P> 0.05). SII demonstrated superior prognostic performance compared to SIRI, NLR and CRP both in cardiovascular mortality (NRI range: 0.798– 1.097; IDI range: 0.094– 0.142, all P< 0.05) and HF rehospitalization (NRI range: 0.254– 0.455; IDI range: 0.016– 0.066, all P< 0.05). However, SII provided no incremental utility for all-cause mortality (P> 0.05).
Conclusion: SII emerges as a superior predictor of adverse cardiovascular outcomes in HFpEF compared to conventional inflammatory markers, supporting its use for risk stratification and as a potential therapeutic guide. Nevertheless, its association with all-cause mortality remains limited.
Keywords: systemic immune-inflammation index, heart failure with preserved ejection fraction, cardiovascular outcomes
1Department of Cardiovascular Medicine, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, People’s Republic of China; 2Department of Cardiovascular Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 3Department of Cardiovascular Medicine, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People’s Republic of China; 4Department of Rheumatology and Immunology, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, People’s Republic of China
Correspondence: Woliang Yuan, Email Ywoliang2022@163.com Muhan Zheng, Email 1078668399@qq.com
Background: The systemic immune-inflammation index (SII), a novel inflammatory index integrating neutrophil, platelet, and lymphocyte counts, predicts outcomes in several cardiovascular diseases, yet its role in heart failure with preserved ejection fraction (HFpEF) remains unclear. We therefore investigated the prognostic value of SII in HFpEF patients and compares its performance against other inflammatory markers, including systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP).
Methods: We retrospectively analyzed a cohort of 316 patients with HFpEF diagnosed between January 2017 and January 2021. All-cause mortality, cardiovascular mortality and HF rehospitalization were assessed over a median follow-up of 24 months. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were employed to evaluate the comparative prognostic performance of SII against SIRI, NLR and CRP.
Results: Logistic regression models revealed that each 100-unit increase in SII was independently associated with elevated risks of cardiovascular mortality (OR:1.321, 95% CI:1.191– 1.467, P< 0.001) and HF rehospitalization (OR:1.168, 95% CI:1.098– 1.241, P< 0.001), but not with all-cause mortality (P> 0.05). SII demonstrated superior prognostic performance compared to SIRI, NLR and CRP both in cardiovascular mortality (NRI range: 0.798– 1.097; IDI range: 0.094– 0.142, all P< 0.05) and HF rehospitalization (NRI range: 0.254– 0.455; IDI range: 0.016– 0.066, all P< 0.05). However, SII provided no incremental utility for all-cause mortality (P> 0.05).
Conclusion: SII emerges as a superior predictor of adverse cardiovascular outcomes in HFpEF compared to conventional inflammatory markers, supporting its use for risk stratification and as a potential therapeutic guide. Nevertheless, its association with all-cause mortality remains limited.
Keywords: systemic immune-inflammation index, heart failure with preserved ejection fraction, cardiovascular outcomes