REVIEW PAPER
Importance of multiparameter inflammatory indices (SII, SIRI, SIIRI) in assessing the risk, severity and prognosis in patients with coronary artery disease
1
Department of Biochemistry and Medical Genetics, Medical University of Silesia in Katowice, Polska
Corresponding author
Justyna Wrona
Zakład Biochemii i Genetyki Medycznej, Śląski Uniwersytet Medyczny w Katowicach, ul. Medyków 18, 40-752 Katowice, Polska
Zakład Biochemii i Genetyki Medycznej, Śląski Uniwersytet Medyczny w Katowicach, ul. Medyków 18, 40-752 Katowice, Polska
KEYWORDS
coronary artery diseasesystemic inflammatory indexsystemic inflammatory response indexsystemic immune inflammation response index
TOPICS
ABSTRACT
Introduction and objective:
Coronary artery disease (CAD) remains one of the leading causes of death, and inflammation plays a key role in its pathogenesis. Currently, new inflammatory indices based on the integration of different blood cell subtypes have been developed and show potential in predicting the course of cardiovascular diseases. The aim of this study was to present the usefulness of three multiparameter inflammatory indices (SII, SIRI,SIIRI) in assessing the risk, severity and prognosis in patients with coronary artery disease.
Review methods:
The analysis included scientific articles published in the PubMed database from 2019–2025, regarding the prognostic value of the SII, SIRI and SIIRI indices in patients with coronary artery disease.
Brief description of the state of knowledge:
The SII index shows a significant association with the severity of coronary atherosclerosis, the risk of CAD, patient survival and the risk of MACE. The SIRI index correlates with the risk of single or multivessel CAD, the risk of severe coronary artery lesions, the occurrence of MACE, and death from any cause. The SIIRI index also showed efficacy in predicting CAD severity, MACE risk and the occurrence of severe CAD.
Summary:
The multi-parameter immune inflammation indices SII, SIRI and SIIRI allow a more precise assessment and prognosis of the course of cardiovascular disease. To obtain these indices, simple parameters are used, which can be easily and affordably obtained from peripheral blood. It is necessary to conduct studies on larger groups of patients to standardize the ranges of these indices. This would enable their use in daily clinical practice to determine risk and predict prognosis in patients with CAD.
Coronary artery disease (CAD) remains one of the leading causes of death, and inflammation plays a key role in its pathogenesis. Currently, new inflammatory indices based on the integration of different blood cell subtypes have been developed and show potential in predicting the course of cardiovascular diseases. The aim of this study was to present the usefulness of three multiparameter inflammatory indices (SII, SIRI,SIIRI) in assessing the risk, severity and prognosis in patients with coronary artery disease.
Review methods:
The analysis included scientific articles published in the PubMed database from 2019–2025, regarding the prognostic value of the SII, SIRI and SIIRI indices in patients with coronary artery disease.
Brief description of the state of knowledge:
The SII index shows a significant association with the severity of coronary atherosclerosis, the risk of CAD, patient survival and the risk of MACE. The SIRI index correlates with the risk of single or multivessel CAD, the risk of severe coronary artery lesions, the occurrence of MACE, and death from any cause. The SIIRI index also showed efficacy in predicting CAD severity, MACE risk and the occurrence of severe CAD.
Summary:
The multi-parameter immune inflammation indices SII, SIRI and SIIRI allow a more precise assessment and prognosis of the course of cardiovascular disease. To obtain these indices, simple parameters are used, which can be easily and affordably obtained from peripheral blood. It is necessary to conduct studies on larger groups of patients to standardize the ranges of these indices. This would enable their use in daily clinical practice to determine risk and predict prognosis in patients with CAD.
REFERENCES (46)
1.
Medina-Leyte DJ, Zepeda-García O, Domínguez-Pérez M, et al. Endothelial Dysfunction, Inflammation and Coronary Artery Disease: Potential Biomarkers and Promising Therapeutical Approaches. Int J Mol Sci. 2021 Apr 8;22(8):3850. https://doi.org/10.3390/ijms22....
2.
Yazdani AN, Pletsch M, Chorbajian A, et al. Biomarkers to monitor the prognosis, disease severity, and treatment efficacy in coronary artery disease. Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(10):675–692. https://doi.org/10.1080/147790....
3.
Vitorino R. Minimally Invasive Versus Invasive Proteomics: Urine and Blood Biomarkers in Coronary Artery Disease. Proteomics Clin Appl. 2025 Jan;19(1):e202400062. https://doi.org/10.1002/prca.2....
4.
Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–477. https://doi.org/10.1093/eurhea....
5.
Khafaji HA, Suwaidi JM. Atypical presentation of acute and chronic coronary artery disease in diabetics. World J Cardiol. 2014;6(8):802–813. https://doi.org/10.4330/wjc.v6....
6.
Dai X, Wiernek S, Evans JP, Runge MS. Genetics of coronary artery disease and myocardial infarction. World J Cardiol. 2016;8(1):1–23. https://doi.org/10.4330/wjc.v8....
7.
Attiq A, Afzal S, Ahmad W, et al. Hegemony of inflammation in atherosclerosis and coronary artery disease. Eur J Pharmacol. 2024 Mar 5;966:176338. https://doi.org/10.1016/j.ejph....
8.
Sreejit G, Johnson J, Jaggers RM, et al. Neutrophils in cardiovascular disease: warmongers, peacemakers, or both? Cardiovasc Res. 2022 Sep 20;118(12):2596–2609. https://doi.org/10.1093/cvr/cv....
9.
Silvestre-Roig C, Braster Q, Ortega-Gomez A, et al. Neutrophils as regulators of cardiovascular inflammation. Nat Rev Cardiol. 2020 Jun;17(6):327–340. https://doi.org/10.1038/s41569....
10.
Ionita MG, van den Borne P, Catanzariti LM, et al. High neutrophil numbers in human carotid atherosclerotic plaques are associated with characteristics of rupture-prone lesions. Arterioscler Thromb Vasc Biol. 2010 Sep;30(9):1842–8. https://doi.org/10.1161/ATVBAH....
11.
Amengual J, Barrett TJ. Monocytes and macrophages in atherogenesis. Curr Opin Lipidol. 2019 Oct;30(5):401–408. https://doi.org/10.1097/MOL.00....
12.
Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest. 2005 Dec;115(12):3378–84. https://doi.org/10.1172/JCI271....
13.
Hansson GK, Hermansson A. The immune system in atherosclerosis. Nat Immunol. 2011 Mar;12(3):204–12. https://doi.org/10.1038/ni.200....
14.
Tudurachi BS, Anghel L, Tudurachi A, et al. Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL-Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients. Int J Mol Sci. 2023 Sep 21;24(18):14378. https://doi.org/10.3390/ijms24....
15.
Ma M, Yu N, Wu B. High systemic immune-inflammation index represents an unfavorable prognosis of malignant pleural mesothelioma. Cancer Manag Res. 2019 May 2;11:3973–3979. https://doi.org/10.2147/CMAR.S....
16.
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 Dec 18;25:9690–9702. https://doi.org/10.12659/MSM.9....
17.
Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014 Dec 1;20(23):6212–22. https://doi.org/10.1158/1078-0....
18.
Xie QK, Chen P, Hu WM, et al. The systemic immune-inflammation index is an independent predictor of survival for metastatic colorectal cancer and its association with the lymphocytic response to the tumor. J Transl Med. 2018 Oct 4;16(1):273. https://doi.org/10.1186/s12967....
19.
Jomrich G, Gruber ES, Winkler D, et al. Systemic Immune-Inflammation Index (SII) Predicts Poor Survival in Pancreatic Cancer Patients Undergoing Resection. J Gastrointest Surg. 2020 Mar;24(3):610–618. https://doi.org/10.1007/s11605....
20.
Zhou ZQ, Pang S, Yu XC, et al. Predictive Values of Postoperative and Dynamic Changes of Inflammation Indexes in Survival of Patients with Resected Colorectal Cancer. Curr Med Sci. 2018 Oct;38(5):798–808. https://doi.org/10.1007/s11596....
21.
Karadeniz FÖ, Karadeniz Y, Altuntaş E. Systemic immune-inflammation index, and neutrophilto-lymphocyte and platelet-to-lymphocyte ratios can predict clinical outcomes in patients with acute coronary syndrome. Cardiovasc J Afr. 2023 May 5;34:1–7. https://doi.org/10.5830/CVJA-2....
22.
Erdoğan M, Erdöl MA, Öztürk S, et al. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med. 2020 Nov;14(16):1553–1561. https://doi.org/10.2217/bmm-20....
23.
Candemir M, Kiziltunç E, Nurkoç S, et al. Relationship Between Systemic Immune-Inflammation Index (SII) and the Severity of Stable Coronary Artery Disease. Angiology. 2021 Jul;72(6):575–581. https://doi.org/10.1177/000331....
24.
Sun H, Liu H, Li J, et al. Analysis of the Clinical Predictive Value of the Novel Inflammatory Indices SII, SIRI, MHR and NHR in Patients with Acute Myocardial Infarction and Their Extent of Coronary Artery Disease. J Inflamm Res. 2024 Oct 15;17:7325–7338. https://doi.org/10.2147/JIR.S4....
25.
Liu Y, Ye T, Chen L, et al. Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease. Coron Artery Dis. 2021 Dec 1;32(8):715–720. https://doi.org/10.1097/MCA.00....
26.
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 May;50(5):e13230. https://doi.org/10.1111/eci.13....
27.
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 Dec 18;25:9690–9701. https://doi.org/10.12659/MSM.9....
28.
Zhao Z, Zhang X, Sun T, et al. Prognostic value of systemic immune-inflammation index in CAD patients: Systematic review and meta-analyses. Eur J Clin Invest. 2024 Feb;54(2):e14100. https://doi.org/10.1111/eci.14....
29.
Zhao Z, Lian H, Liu Y, et al. Application of systemic inflammation indices and lipid metabolism-related factors in coronary artery disease. Coron Artery Dis. 2023 Aug 1;34(5):306–313. https://doi.org/10.1097/MCA.00....
30.
Bian X, He J, Zhang R, et al. The Combined Effect of Systemic Immune-Inflammation Index and Type 2 Diabetes Mellitus on the Prognosis of Patients Undergoing Percutaneous Coronary Intervention: A Large-Scale Cohort Study. J Inflamm Res. 2023 Dec 27;16:6415–6429. https://doi.org/10.2147/JIR.S4....
31.
Urbanowicz T, Michalak M, Al-Imam A, et al. The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery. Diagnostics (Basel). 2022;12(3):634. https://doi.org/10.3390/diagno....
32.
Dziedzic EA, Gąsior JS, Tuzimek A, et al. Investigation of the Associations of Novel Inflammatory Biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)-With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence. Int J Mol Sci. 2022 Aug 23;23(17):9553. https://doi.org/10.3390/ijms23....
33.
Chao B, Ju X, Zhang L, et al. A Novel Prognostic Marker Systemic Inflammation Response Index (SIRI) for Operable Cervical Cancer Patients. Front Oncol. 2020 May 13;10:766. https://doi.org/10.3389/fonc.2....
34.
Qi Q, Zhuang L, Shen Y, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016 Jul 15;122(14):2158–67. https://doi.org/10.1002/cncr.3....
35.
Chen Y, Jin M, Shao Y, et al. Prognostic Value of the Systemic Inflammation Response Index in Patients with Adenocarcinoma of the Oesophagogastric Junction: A Propensity Score-Matched Analysis. Dis Markers. 2019 Nov 4;2019:4659048. https://doi.org/10.1155/2019/4....
36.
Geng Y, Zhu D, Wu C, et al. A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma. Int Immunopharmacol. 2018 Dec;65:503–510. https://doi.org/10.1016/j.inti....
37.
Urbanowicz T, Michalak M, Komosa A, et al. Predictive value of systemic inflammatory response index (SIRI) for complex coronary artery disease occurrence in patients presenting with angina equivalent symptoms. Cardiol J. 2024;31(4):583–595. https://doi.org/10.5603/CJ.a20....
38.
He T, Luo Y, Wan J, et al. Analysis of the correlation between the Systemic Inflammatory Response Index and the severity of coronary vasculopathy. Biomol Biomed. 2024 Oct 17;24(6):1726–1734. https://doi.org/10.17305/bb.20....
39.
Q X Li, J Q Yuan, The association between elevated systemic inflammation response index and long-term mortality in patients with triple-vessel coronary disease, European Heart Journal, Volume 45, Issue Supplement_1, October 2024, ehae666.1314. https://doi.org/10.1093/eurhea....
40.
Wei X, Zhang Z, Wei J, et al. Association of systemic immune inflammation index and system inflammation response index with clinical risk of acute myocardial infarction. Front Cardiovasc Med. 2023 Aug 30;10:1248655. https://doi.org/10.3389/fcvm.2....
41.
Yang P, Xue R, Wei Y, et al. Prognostic value of the derived inflammatory marker SIRI in postmenopausal women with coronary artery disease. Front Cardiovasc Med. 2024 Dec 20;11:1418781. https://doi.org/10.3389/fcvm.2....
42.
Li T, Wang P, Wang X, et al. Prognostic significance of inflammation in patients with coronary artery disease at low residual inflammatory risk. iScience. 2023 Sep 28;26(11):108060. https://doi.org/10.1016/j.isci....
43.
Mangalesh S, Dudani S, Mahesh NK. Development of a Novel Inflammatory Index to Predict Coronary Artery Disease Severity in Patients With Acute Coronary Syndrome. Angiology. 2024 Mar;75(3):231–239. https://doi.org/10.1177/000331....
44.
Li Y, Bai G, Gao Y, et al. The Systemic Immune Inflammatory Response Index Can Predict the Clinical Prognosis of Patients with Initially Diagnosed Coronary Artery Disease. J Inflamm Res. 2023 Nov 2;16:5069–5082. https://doi.org/10.2147/JIR.S4....
45.
Gao Y, Bai G, Li Y, et al. Prognosis impact of multiple novel lymphocyte-based inflammatory indices in patients with initially diagnosed coronary artery disease. Immun Inflamm Dis. 2024 Sep;12(9):e1340. https://doi.org/10.1002/iid3.1....
46.
Bani Hani DA, Alshraideh JA, Saleh A, et al. Lymphocyte-based inflammatory markers: Novel predictors of significant coronary artery disease ,. Heart Lung. 2025 Mar-Apr;70:23–29. https://doi.org/10.1016/j.hrtl....
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| ISSN: | 2083-4543 |
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