# Systemic immune-inflammation index, neutrophil to high-density lipoprotein ratio and pre-hospital delay: promising biomarkers for predicting the prognosis of patients with acute ST-elevation myocardial infarction

## TL;DR

This study shows that higher levels of SII, NHR, and pre-hospital delay are linked to worse outcomes in heart attack patients.

## Contribution

The study introduces SII, NHR, and pre-hospital delay as novel combined biomarkers for predicting poor prognosis in STEMI patients.

## Key findings

- SII, NHR, and PHDT levels were significantly higher in patients with MACE.
- Combining SII, NHR, and PHDT improved predictive accuracy (AUC 0.819) for MACE.
- Higher SII, NHR, and PHDT levels correlated with increased MACE incidence in survival analysis.

## Abstract

Research has confirmed the relationship between acute inflammation, lipid metabolism disorders, and the occurrence of coronary heart disease. However, no studies have analyzed the association between inflammation and lipid-related indicators with the poor prognosis of STEMI (ST-Elevation Myocardial Infarction) patients.

The retrospective cohort study enrolled 556 patients diagnosed with STEMI. According to 18 Months follow-up outcomes, participants were categorized into either the MACE group or the non MACE group. Additionally, patients were stratified based on their systemic immune-inflammatory index (SII), neutrophil to high-density lipoprotein ratio (NHR), and pre-hospital delay time) levels using optimal cut-off points. The predictive value of SII, NHR and PHDT alone or combined was evaluated using receiver operating characteristic (ROC) curves. Risk factors of MACE in STEMI patients were detected by Multivariable Cox regression analysis. In addition, the Kaplan–Meier approach was applied to assess the long-term survival rates of different. levels of SII, NHR and PHDT in STEMI patient.

The levels of SII, NHR and PHDT were significantly higher in the MACE group as compared to the non-MACE group. The ROC curve analysis demonstrated that SII, NHR and PHDT possess considerable predictive power for the development of MACE in STEMI patients. Furthermore, the area under the curve of the combination of SII, NHR and PHDT was 0.819 (95% CI: 0.78–0.85, P < 0.01), which was better than each individual indicator separately. According to the Kaplan–Meier survival curve, patients exhibiting higher SII, NHR and PHDT had an increased incidence of MACE. Univariate and multivariable analyses revealed that SII, NHR and PHDT were independent predictors for the occurrence of MACE.

Elevated levels of SII, NHR and PHDT correlate closely with MACE in patients with STEMI, and demonstrate predictive value.