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Systemic Immune-Inflammation Index as an independent predictor of in-hospital morbidity in diabetic patients with ST-elevation myocardial infarction
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 31 July 2026
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Diabetic patients presenting with ST-elevation myocardial infarction (STEMI) are particularly vulnerable to unfavorable in‑hospital outcomes. We examined the prognostic value of the systemic immune‑inflammation index (SII) for predicting in‑hospital morbidity in a prospective cohort of 108 diabetic patients with STEMI; patients were classified by clinical outcome into morbid (n=57) and non‑morbid (n=51) groups. Demographic characteristics, clinical findings, laboratory results, and angiographic data were recorded. In-hospital morbidity occurred in 52.8% of patients. Multivariate logistic regression identified prior myocardial infarction [p=0.038, odds ratio (OR)=3.34, 95% confidence interval (CI): 1.07-11.01], three‑vessel disease (p=0.019, OR=3.81, 95% CI: 1.26-19.51), and SII (p=0.022, OR=3.16, 95% CI: 1.12-14.5) as independent predictors of morbidity. SII demonstrated good discriminatory ability for predicting morbidity with an area under the receiver operating characteristic curve of 0.718 (95% CI: 0.662-0.844, p<0.001); at a cut‑off >604.75 the sensitivity was 77% and specificity 63%. These findings suggest that SII is a useful and readily available inflammatory marker for predicting in‑hospital morbidity among diabetic patients with STEMI.
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Chen S, Chen Y, Liu B, et al. Does diabetes mellitus increase the short- and long-term mortality in patients with critical acute myocardial infarction? Front Endocrinol 2021;12:797049.
Mohammedi MKM, Altaweel RB, Gburi AKKA. Exploring the role of non-HDL cholesterol in acute coronary syndrome: a case-control study. Pak Heart J 2024;57:13-7.
Yoon GS, Park HC, Choi JH, et al. Association between on-admission neutrophil-to-lymphocyte ratio and mechanical complications and mortality in patients with STEMI. J Korean Med Sci 2021;36:e131.
Babes EE, Radu AF, Cretu NA, et al. Risk stratification in acute coronary syndromes: The systemic immune-inflammation index as prognostic marker. Med Sci 2025;13:116.
Bruno M, Bizzarri N, Teodorico E, et al. The potential role of systemic inflammatory markers in predicting recurrence in early-stage cervical cancer. Eur J Surg Oncol 2024;50:107311.
Wenpei G, Yuan L, Liangbo L, et al. Predictive value of preoperative inflammatory indexes for postoperative early recurrence of hepatitis B-related hepatocellular carcinoma. Front Oncol 2023;13:1142168.
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 2022;12:634.
Zhang W, Jia H, Zhao X, et al. Predictive value of cumulative SII for MACE in STEMI patients after PCI. Medicine 2025;104:e41983.
Orhan AL, Saylik F, Cicek V, et al. Evaluating the systemic immune-inflammation index for in-hospital and long-term mortality in elderly non-ST-elevation myocardial infarction patients. Aging Clin Exp Res 2022;34:1687-95.
Li Q, Ma X, Shao Q, et al. Prognostic impact of multiple lymphocytebased inflammatory indices in acute coronary syndrome patients. Front Cardiovasc Med 2022;9:811790.
Zhao Y, Zhao S, Shi Y, et al. The Predictive Value of the Systemic Immune-Inflammation Index for Cardiovascular Events in Chronic Total Occlusion Patients Who Prior Coronary Artery Bypass Grafting. J Inflamm Res 2024;17:8611-23.
Ye Z, Hu T, Wang J, et al. Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: a systematic review and meta-analysis. Front Cardiovasc Med 2022;9:933913.
Esenboga K, Kurtul A, Yamantürk YY, et al. Systemic immune-inflammation index predicts no-reflow phenomenon after primary percutaneous coronary intervention. Acta Cardiol. 2022;77:59-65.
Tosu AR, Kalyoncuoglu M, Biter H, et al. Prognostic value of systemic immune-inflammation index for major adverse cardiac events and mortality in severe aortic stenosis patients after TAVI. Medicina 2021;57:588.
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;16:6415-29.
Anzai A, Ko S, Fukuda K. Immune and inflammatory networks in myocardial infarction: current research and its potential implications for the clinic. Int J Mol Sci 2022;23:5214.
Mauler M, Herr N, Schoenichen C, et al. Platelet serotonin aggravates myocardial ischemia/reperfusion injury via neutrophil degranulation. Circulation 2019;139:918-31.
Zhao WM, Tao SM, Liu GL. Neutrophil-to-lymphocyte ratio in relation to the risk of all-cause mortality and cardiovascular events in patients with chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2020;42:1059-66.
Broijersen A, Hamsten A, Eriksson M, et al. Platelet activity in vivo in hyperlipoproteinemia – importance of combined hyperlipidemia. Thromb Haemost 1998;79:268-75.
Totani L, Evangelista V. Platelet-leukocyte interactions in cardiovascular disease and beyond. Arterioscler Thromb Vasc Biol 2010;30:2357-61.
Su G, Zhang Y, Xiao R, et al. Systemic immune-inflammation index as a promising predictor of mortality in patients with acute coronary syndrome: a real-world study. J Int Med Res 2021;49:3000605211016274.
Liu Y, Liu J, Liu L, et al. Association of systemic inflammatory response index and pan-immune-inflammation-value with long-term adverse cardiovascular events in st-segment elevation myocardial infarction patients after primary percutaneous coronary intervention. J Inflamm Res 2023;16:3437-54.
Wei X, Zhang Z, Wei J, Luo C. Association of systemic immune inflammation index and system inflammation response index with clinical risk of acute myocardial infarction. Front Cardiovasc Med 2023;10:1248655.
Luo J, Qin X, Zhang X, et al. Prognostic implications of systemic immune-inflammation index in myocardial infarction patients with and without diabetes: insights from the NOAFCAMI-SH registry. Cardiovasc Diabetol 2024;23:41.
How to Cite
Systemic Immune-Inflammation Index as an independent predictor of in-hospital morbidity in diabetic patients with ST-elevation myocardial infarction. (2026). Italian Journal of Medicine. https://doi.org/10.4081/itjm.2026.2563
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