Prognostic Value of the Systemic Inflammatory Response Index in Patients with Acute Coronary Syndrome and Obstructive Sleep Apnea

Qian He,1,2 Yun Zhou,1 Xueying Tong,3 Lei Zhen,1 Shutian Shi,1 Wei Gong,1,4 Shaoping Nie1 1Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Cardiovascular Disease Treatment Center, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China; 3Department of Geriatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China; 4Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaCorrespondence: Shaoping Nie, Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, People’s Republic of China, Email [email protected] Wei Gong, Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100005, People’s Republic of China, Email [email protected]: This study aimed to investigate the effects of the systemic inflammatory response index (SIRI) on the long-term prognosis of patients with acute coronary syndrome (ACS) and obstructive sleep apnea (OSA).Patients and Methods: This prospective cohort study enrolled patients with ACS and OSA at the Beijing Anzhen Hospital between June 2015 and January 2020. The SIRI was calculated at admission for all patients. Patients with SIRI ≥ 1.16 × 109/L were classified into the high SIRI group based on the optimal cutoff value for predicting major adverse cardiovascular and cerebrovascular events (MACCE) determined by the receiver operating characteristic (ROC) curve of our cohort study. The other patients were categorized into the low SIRI group. The primary endpoint was a composite of MACCE, including cardiovascular death, recurrent myocardial infarction (MI), stroke, and ischemia-driven revascularization.Results: A total of 1011 patients with ACS and OSA were enrolled, 435 of whom (43%) were in the high SIRI group. Over a median follow-up of 2.8 (1.4– 3.6) years, 179 patients experienced MACCE. Kaplan–Meier survival analysis showed a higher cumulative incidence of MACCE in the high-SIRI group (log-rank P < 0.001). A restricted cubic spline analysis also showed a monotonic increase with a greater SIRI value for MACCE (P = 0.011). After adjusting for clinically relevant confounders, a high SIRI was independently associated with elevated MACCE risk (adjusted HR = 1.44, 95% CI 1.02– 2.05, P = 0.039).Conclusion: A high SIRI was associated with poorer clinical outcomes during long-term follow-up in patients with ACS and OSA.Keywords: systemic inflammatory response index, acute coronary syndrome, obstructive sleep apnea, prognosis