Biomarkers in medicine · 2026
Time-dependent prognostic performance of inflammatory biomarkers after AMI: results from the INFINITY study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Mitsis A, Tsiaktani K, Tasoulis S K, Lakoumentas J, Karmioti G, Kyriakou M, Sokratous S, Drakomathioulakis M, Eftychiou C, Tzikas S, Kadoglou N P E, Kassimis G
Аннотация
BACKGROUND: Inflammatory biomarkers derived from routine blood counts reflect immune activation in acute myocardial infarction (AMI). However, their temporal prognostic relevance after AMI remains uncertain.
METHODS: This prospective sub-study of the INFINITY trial (NCT06065514) included 100 consecutive patients with AMI. Five admission-derived inflammatory biomarkers were evaluated: systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). Major adverse cardiovascular events (MACEs) were assessed cumulatively during hospitalization and at 1, 6, and 12 months. Associations were evaluated using non-parametric tests, receiver operating characteristic analysis, Kaplan-Meier survival curves, and parsimonious logistic regression adjusted for GRACE score.
RESULTS: No inflammatory biomarker predicted in-hospital events. At 1-month, elevated SIRI was associated with MACEs (p = 0.017; AUC 0.77), identifying early post-discharge vulnerability. At 6 months, SII (p = 0.036), NLR (p = 0.031), and SIRI (p = 0.032) were associated with adverse outcomes with moderate discrimination (AUC ≈0.69). Associations were attenuated after adjustment for the GRACE score. Nobiomarker demonstrated consistent prognostic value at 12 months.
CONCLUSIONS: Admission-derived inflammatory biomarkers show a dynamic prognostic profile after AMI.SIRI identifies early risk, while broader inflammatory activation relates to mid-term outcomes, suggesting complementary value for biomarker-based risk stratification.
METHODS: This prospective sub-study of the INFINITY trial (NCT06065514) included 100 consecutive patients with AMI. Five admission-derived inflammatory biomarkers were evaluated: systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). Major adverse cardiovascular events (MACEs) were assessed cumulatively during hospitalization and at 1, 6, and 12 months. Associations were evaluated using non-parametric tests, receiver operating characteristic analysis, Kaplan-Meier survival curves, and parsimonious logistic regression adjusted for GRACE score.
RESULTS: No inflammatory biomarker predicted in-hospital events. At 1-month, elevated SIRI was associated with MACEs (p = 0.017; AUC 0.77), identifying early post-discharge vulnerability. At 6 months, SII (p = 0.036), NLR (p = 0.031), and SIRI (p = 0.032) were associated with adverse outcomes with moderate discrimination (AUC ≈0.69). Associations were attenuated after adjustment for the GRACE score. Nobiomarker demonstrated consistent prognostic value at 12 months.
CONCLUSIONS: Admission-derived inflammatory biomarkers show a dynamic prognostic profile after AMI.SIRI identifies early risk, while broader inflammatory activation relates to mid-term outcomes, suggesting complementary value for biomarker-based risk stratification.