Evaluation of systemic immune inflammation and triglyceride/glucose indices in the development of no-reflow in ST elevation myocardial infarction

Çağrı Zorlu, Yağmur Demirezen, Sefa Erdi Ömür, Cemal Köseoğlu

Abstract

Background: No-reflow is a phenomenon of unclear pathophysiology that occurs in approximately 5-10% of patients after primary percutaneous coronary intervention. Recently, the relationship between the systemic immune- inflammatory index (SII), which reflects inflammatory status, and the triglyceride-glucose index (TyG), which reflects insulin resistance, as well as heart disease and its complications, has been under investigation. In this study, we aimed to evaluate the ability of a combination of the SII and TyG, routinely obtained at admission, to identify ST-segment elevation myocardial infarction (STEMI) patients at risk of no-reflow.
Methods: Between 2018 and 2024, 2382 patients with STEMI, who underwent percutaneous coronary intervention (PCI), were included. The patients were divided into two groups according to whether no-reflow developed or not, and the relationships between the SII and TyG, as well as their combined use in the prediction of no-reflow, were evaluated. Receiver operating curve (ROC) analyses were performed to predict the development of no-reflow.
Results: In the ROC analyses, the cut-off values of SII and TyG for best predicting no-reflow were 421 and 7.82, respectively. Using the combination of these two markers was the most powerful predictor of no-reflow risk when included in a single variable, such as high SII or high TyG. Furthermore, the co-presence of a high SII and a high TyG showed the highest specificity (84%) and sensitivity (85%) for no-reflow
Conclusion: The combination of the SII and TyG, simple and cost-effective risk assessments, may be a more reliable prognostic indicator of the development of no-reflow in STEMI patients undergoing PCI than the use of the SII and TyG alone.