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Zhang B, Li Y, Peng A, Liu C, Lin J, Feng Y, Wan J. Association between the pan-immune-inflammation value and coronary collateral circulation in chronic total coronary occlusive patients. BMC Cardiovasc Disord 2024; 24:458. [PMID: 39198732 PMCID: PMC11351751 DOI: 10.1186/s12872-024-04139-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 08/21/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Inflammation and immunity play important roles in the formation of coronary collateral circulation (CCC). The pan-immune-inflammation value (PIV) is a novel marker for evaluating systemic inflammation and immunity. The study aimed to investigate the association between the PIV and CCC formation in patients with chronic total occlusion (CTO). METHODS This retrospective study enrolled 1150 patients who were diagnosed with CTO through coronary angiographic (CAG) examinations from January 2013 to December 2021 in China. The Cohen-Rentrop criteria were used to catagorize CCC formation: good CCC formation (Rentrop grade 2-3) and poor CCC formation group (Rentrop grade 0-1). Based on the tertiles of the PIV, all patients were classified into three groups as follows: P1 group, PIV ≤ 237.56; P2 group, 237.56< PIV ≤ 575.18; and P3 group, PIV > 575.18. RESULTS A significant relationship between the PIV and the formation of CCC was observed in our study. Utilizing multivariate logistic regression and adjusting for confounding factors, the PIV emerged as an independent risk factor for poor CCC formation. Notably, the restricted cubic splines revealed a dose-response relationship between the PIV and risk of poor CCC formation. In terms of predictive accuracy, the area under the ROC curve (AUC) for PIV in anticipating poor CCC formation was 0.618 (95% CI: 0.584-0.651, P < 0.001). Furthermore, the net reclassification index (NRI) and integrated discrimination index (IDI) for PIV, concerning the prediction of poor CCC formation, were found to be 0.272 (95% CI: 0.142-0.352, P < 0.001) and 0.051 (95% CI: 0.037-0.065, P < 0.001), respectively. It's noteworthy that both the NRI and IDI values were higher for PIV compared to other inflammatory biomarkers, suggesting its superiority in predictive capacity. CONCLUSIONS PIV was associated with the formation of CCC. Notably, PIV exhibited potential as a predictor for poor CCC formation and showcased superior predictive performance compared to other complete blood count-based inflammatory biomarkers.
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Affiliation(s)
- Bing Zhang
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Ya Li
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Aihong Peng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Cuiyi Liu
- Department of Cardiology, Xi 'An Da Xing Hospital, Xi 'an, 710000, Shanxi, China
| | - Jiesheng Lin
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Pettenkofer School of Public Health, LMU Munich, 85764, Munich, Germany
| | - Yujia Feng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Jing Wan
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
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Bilgin M, Akkaya E, Dokuyucu R. The Role of Triglyceride/HDL Ratio, Triglyceride-Glucose Index, and Pan-Immune-Inflammation Value in the Differential Diagnosis of Acute Coronary Syndrome and Predicting Mortality. J Clin Med 2024; 13:4832. [PMID: 39200973 PMCID: PMC11355828 DOI: 10.3390/jcm13164832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/09/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
Objectives: We aimed to evaluate the predictive importance of various clinical and laboratory parameters in the differential diagnosis of Acute Coronary Syndrome (ACS). Understanding these predictors is critical for improving diagnostic accuracy, guiding therapeutic decisions, and ultimately enhancing patient outcomes. Methods: The study included a total of 427 patients diagnosed with ACS, comprising 142 with unstable angina, 142 with non-ST elevation myocardial infarction (NSTEMI), and 143 with ST elevation myocardial infarction (STEMI). The data were collected from medical records of patients treated at a tertiary care hospital between January 2020 and December 2024. In addition to other biochemical parameters, triglyceride/HDL ratio (THR), triglyceride-glucose index (TGI), and Pan-Immune-Inflammation Value (PIV) were calculated and compared. Results: THR, TGI, PIV, and mortality rate were statistically higher in the STEMI group (p = 0.034, p = 0.031, p = 0.022, p = 0.045, respectively). The risk factors were found to be significantly associated with STEMI in the multiple logistic regression analysis and included age, total cholesterol, triglycerides, diabetes mellitus, smoking, cTnI, LVEF, THR, TGI, and PIV. High THR increases the risk of STEMI (AUC = 0.67, 95% CI: 0.62-0.72, p = 0.020). High THR increases the risk of mortality in ACS patients (AUC = 0.70, 95% CI: 0.65-0.75, p = 0.004). THRs above 3.5 are associated with higher risk. Sensitivity is 75% and specificity is 60%. High TGI increases the risk of mortality in ACS patients (AUC = 0.73, 95% CI: 0.68-0.78, p = 0.007). TGIs above 8.5 are associated with higher risk. Sensitivity is 78% and specificity is 63%. High PIVs increase the risk of mortality in ACS patients (AUC = 0.75, 95% CI: 0.70-0.80, p = 0.009). PIVs above 370 are associated with higher risk. Sensitivity is 80% and specificity is 65%. The combination of TGI, THR, PIV, and cTnI has the highest predictive capability over individual parameters for STEMI and mortality. Conclusions: We found that age, total cholesterol, triglycerides, cTnI, THR, TGI, and PIV increase, low LVEF, presence of diabetes mellitus, and smoking have predictive values for STEMI and mortality in patients with ACS. Unlike the studies in the literature, this is the first study in which cTnI, THR, TGI, and PIV values were evaluated together in ACS and mortality prediction.
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Affiliation(s)
- Murat Bilgin
- Department of Cardiology, Private Aktif International Hospital, Yalova 77720, Turkey
| | - Emre Akkaya
- Department of Cardiology, Bossan Hospital, Gaziantep 27580, Turkey;
| | - Recep Dokuyucu
- Department of Physiology, Medical Specialization Training Center (TUSMER), Ankara 06230, Turkey;
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Chen J, Luo C, Tan D, Li Y. J-shaped associations of pan-immune-inflammation value and systemic inflammation response index with stroke among American adults with hypertension: evidence from NHANES 1999-2020. Front Neurol 2024; 15:1417863. [PMID: 39144717 PMCID: PMC11322096 DOI: 10.3389/fneur.2024.1417863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/23/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction Stroke, a leading cause of death and disability worldwide, is primarily ischemic and linked to hypertension. Hypertension, characterized by systemic chronic inflammation, significantly increases stroke risk. This study explores the association of novel systemic inflammatory markers (SII, PIV, SIRI) with stroke prevalence in hypertensive U.S. adults using NHANES data. Methods We analyzed data from hypertensive participants in the NHANES 1999-2020 survey, excluding those under 20, pregnant, or with missing data, resulting in 18,360 subjects. Systemic inflammatory markers (SII, PIV, SIRI) were calculated from blood counts. Hypertension and stroke status were determined by self-report and clinical measurements. Covariates included sociodemographic, lifestyle, and medical history factors. Weighted statistical analyses and multivariate logistic regression models were used to explore associations, with adjustments for various covariates. Ethical approval was obtained from the NCHS Ethics Review Board. Results In a cohort of 18,360 hypertensive individuals (mean age 56.652 years), 7.25% had a stroke. Stroke patients were older, had lower PIR, and were more likely to be female, single, less educated, smokers, non-drinkers, physically inactive, and have diabetes and CHD. Multivariate logistic regression showed that SII was not significantly associated with stroke. However, PIV and SIRI were positively associated with stroke prevalence. Each unit increase in lnPIV increased stroke odds by 14% (OR = 1.140, p = 0.0022), and lnSIRI by 20.6% (OR = 1.206, p = 0.0144). RCS analyses confirmed J-shaped associations for lnPIV and lnSIRI with stroke. Stratified analyses identified gender and smoking as significant effect modifiers. Smoking was significantly associated with elevated PIV, SIRI, and SII levels, especially in current smokers. Conclusion Elevated PIV and SIRI levels significantly increase stroke prevalence in hypertensive individuals, notably among males and smokers. A predictive model with PIV, SIRI, and sociodemographic factors offers strong clinical utility.
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Affiliation(s)
| | | | - Dianhui Tan
- Department of Neurosurgery, the First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Xu HB, Xu YH, He Y, Lin XH, Suo Z, Shu H, Zhang H. Association between admission pan-immune-inflammation value and short-term mortality in septic patients: a retrospective cohort study. Sci Rep 2024; 14:15205. [PMID: 38956306 PMCID: PMC11219806 DOI: 10.1038/s41598-024-66142-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
Pan-Immune-Inflammation Value (PIV) has recently received more attention as a novel indicator of inflammation. We aimed to evaluate the association between PIV and prognosis in septic patients. Data were extracted from the Medical Information Mart for Intensive Care IV database. The primary and secondary outcomes were 28-day and 90-day mortality. The association between PIV and outcomes was assessed by Kaplan-Meier curves, Cox regression analysis, restricted cubic spline curves and subgroup analysis. A total of 11,331 septic patients were included. Kaplan-Meier curves showed that septic patients with higher PIV had lower 28-day survival rate. In multivariable Cox regression analysis, log2-PIV was positively associated with the risk of 28-day mortality [HR (95% CI) 1.06 (1.03, 1.09), P < 0.001]. The relationship between log2-PIV and 28-day mortality was non-linear with a predicted inflection point at 8. To the right of the inflection point, high log2-PIV was associated with an increased 28-day mortality risk [HR (95% CI) 1.13 (1.09, 1.18), P < 0.001]. However, to the left of this point, this association was non-significant [HR (95% CI) 1.01 (0.94, 1.08), P = 0.791]. Similar results were found for 90-day mortality. Our study showed a non-linear relationship between PIV and 28-day and 90-day mortality risk in septic patients.
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Affiliation(s)
- Hong-Bo Xu
- Department of Critical Care Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital/The 6th Affiliated Hospital of Shenzhen University Health Science Center, 89 Taoyuan Road, Shenzhen, 518052, China
| | - Yu-Hong Xu
- Department of Pharmacy, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Ying He
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Xiao-Hua Lin
- Department of Critical Care Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital/The 6th Affiliated Hospital of Shenzhen University Health Science Center, 89 Taoyuan Road, Shenzhen, 518052, China
| | - Zhijun Suo
- Department of Critical Care Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital/The 6th Affiliated Hospital of Shenzhen University Health Science Center, 89 Taoyuan Road, Shenzhen, 518052, China
| | - Huaqing Shu
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277, Jiefang Avenue, Wuhan, 430022, China.
| | - Haigang Zhang
- Department of Critical Care Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital/The 6th Affiliated Hospital of Shenzhen University Health Science Center, 89 Taoyuan Road, Shenzhen, 518052, China.
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Jin C, Li X, Luo Y, Zhang C, Zuo D. Associations between pan-immune-inflammation value and abdominal aortic calcification: a cross-sectional study. Front Immunol 2024; 15:1370516. [PMID: 38605946 PMCID: PMC11007162 DOI: 10.3389/fimmu.2024.1370516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Background Abdominal aortic calcification (AAC) pathogenesis is intricately linked with inflammation. The pan-immune-inflammation value (PIV) emerges as a potential biomarker, offering reflection into systemic inflammatory states and assisting in the prognosis of diverse diseases. This research aimed to explore the association between PIV and AAC. Methods Employing data from the National Health and Nutrition Examination Survey (NHANES), this cross-sectional analysis harnessed weighted multivariable regression models to ascertain the relationship between PIV and AAC. Trend tests probed the evolving relationship among PIV quartiles and AAC. The study also incorporated subgroup analysis and interaction tests to determine associations within specific subpopulations. Additionally, the least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression were used for characteristics selection to construct prediction model. Nomograms were used for visualization. The receiver operator characteristic (ROC) curve, calibration plot and decision curve analysis were applied for evaluate the predictive performance. Results From the cohort of 3,047 participants, a distinct positive correlation was observed between PIV and AAC. Subsequent to full adjustments, a 100-unit increment in PIV linked to an elevation of 0.055 points in the AAC score (β=0.055, 95% CI: 0.014-0.095). Categorizing PIV into quartiles revealed an ascending trend: as PIV quartiles increased, AAC scores surged (β values in Quartile 2, Quartile 3, and Quartile 4: 0.122, 0.437, and 0.658 respectively; P for trend <0.001). Concurrently, a marked rise in SAAC prevalence was noted (OR values for Quartile 2, Quartile 3, and Quartile 4: 1.635, 1.842, and 2.572 respectively; P for trend <0.01). Individuals aged 60 or above and those with a history of diabetes exhibited a heightened association. After characteristic selection, models for predicting AAC and SAAC were constructed respectively. The AUC of AAC model was 0.74 (95%CI=0.71-0.77) and the AUC of SAAC model was 0.84 (95%CI=0.80-0.87). According to the results of calibration plots and DCA, two models showed high accuracy and clinical benefit. Conclusion The research findings illuminate the potential correlation between elevated PIV and AAC presence. Our models indicate the potential utility of PIV combined with other simple predictors in the assessment and management of individuals with AAC.
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Affiliation(s)
- Chen Jin
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xunjia Li
- Department of Nephrology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
- Chongqing Precision Medical Industry Technology Research Institute, Chongqing, China
| | - Yuxiao Luo
- University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Cheng Zhang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Deyu Zuo
- Chongqing Precision Medical Industry Technology Research Institute, Chongqing, China
- Department of Rehabilitation Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
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Turan YB. The prognostic importance of the pan-immune-inflammation value in patients with septic shock. BMC Infect Dis 2024; 24:69. [PMID: 38200436 PMCID: PMC10777599 DOI: 10.1186/s12879-023-08963-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION The purpose of this study was to determine whether the pan-immune-inflammation value (PIV), a novel biomarker combining neutrophil platelet, monocyte, and lymphocyte counts, some of the most widespread indicators of systemic inflammation, can predict mortality and prognosis in patients admitted to the intensive care unit (ICU) with septic shock. METHOD This prospective study was performed with 82 patients aged 18 or over admitted to a tertiary ICU with diagnoses of septic shock. Patients with hematological disease and neutropenia were excluded. PIV was calculated with the formula [neutrophil count (103/μL) × platelet count (103/μL) × monocyte count (103/μL)]/lymphocyte count (103/μL). RESULTS Median age, presence of hypertension, Acute Physiology and Chronic Health Evaluation II (APACHE II) levels, and neutrophil, monocyte, and platelet counts were lower in the low-PIV group than in the high-PIV group (p < 0.05). The highest area under ROC curve (AUC) was determined for Sequential Organ Failure Assessment (SOFA) (0.94 (0.89 - 0.99)), followed by Glasgow Coma Scale (GCS) (0.81 (0.70 - 0.91)), APACHE II (0.80 (0.69 - 0.91)) and lactate (0.77 (0.67 - 0.88)). Median survival was longer in the low-PIV group than in the high-PIV group (28 (15.25 - 40.76) vs 16 (9.46 - 22.55) days, respectively, p < 0.05). The univariate Cox proportional hazards (CPH) model showed that high PIV (HR = 2.13 (1.03-4.38)), low GCS (HR = 3.31 (1.34 - 8.15)), high SOFA (HR = 9.41 (2.86 - 30.95)), high APACHE II (HR = 3.08 (1.47 - 6.45)), high lactate (HR = 6.56 (2.73 - 15.75)), and high procalcitonin (PCT) (HR = 2.73 (1.11 - 6.69)) values were associated with a decreased survival time among ICU patients (p < 0.05). The multivariate CPH model showed the age-adjusted risk estimates for these six laboratory parameters. High lactate (HR = 7.97 (2.19 - 29.08)) and high SOFA scores (HR = 4.85 (1.22 - 19.32)) were significantly associated with shorter survival in ICU patients (p < 0.05). CONCLUSION The findings of this research suggest that PIV could predict the longer survival in patients with septic shock. Despite PIV score's capability to show inflammation, it is not significantly associated with mortality in the multivariate analysis.
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Affiliation(s)
- Yasemin Bozkurt Turan
- Department of Critical Care, Marmara University Faculty of Medicine, Pendik, Istanbul, 34899, Turkey.
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Magoon R. Immune-inflammation mapping in Guillain-Barré syndrome: Further insights. Clin Neurol Neurosurg 2023; 235:108028. [PMID: 37939620 DOI: 10.1016/j.clineuro.2023.108028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Rohan Magoon
- Department of Anaesthesia, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi 110001, India.
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