Association of Systemic Inflammation Indices With Mortality in Coronary Atherosclerosis Patients With and Without Standard Modifiable Risk Factors.

Background: Standard modifiable risk factors (SMuRFs) are important causative factors leading to coronary atherosclerosis. However, a significant number of individuals develop coronary atherosclerosis despite the absence of SMuRFs. Inflammation is another major cause of atherosclerosis, and this study aims to investigate the association of the novel inflammatory markers systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) with mortality in patients with coronary heart disease (CHD) with and without SMuRFs. Methods: In this study, we included 1708 CHD participants from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Patients were categorized into ≥ 1SMuRF and SMuRF-less groups by questionnaire and serologic testing. SII and SIRI were categorized into four groups according to quartiles. Multivariate weighted Cox regression was used to explore the risk factors associated with mortality in patients with or without SMuRFs. Restricted cubic spline (RCS) curve was used to assess their nonlinear correlation. Results: In patients with ≥1 SMuRF, all-cause mortality (SII:hazard ratio [HR] 1.47, 95% confidence interval [CI] 1.18-1.84, Conclusions: The findings showed that SII and SIRI were positively associated with all-cause mortality in a population with CHD irrespective of the presence or absence of SMuRFs. The present study suggests that inflammation may be an important factor in the poor prognosis of patients with no specific cardiovascular risk factors, which needs to be further argued by more prospective studies.