Cardiovascular Journal of Africa

Prognostic value of systemic immune-inflammation index in patients with non-valvular atrial fibrillation: SII score in patients using DOACs

Kahraman Cosansu, Sabiye Yilmaz, Cagin Mustafa Ureyen, Mustafa Gokhan Vural
Abstract
Background: The systemic immune-inflammation index (SII) is a simple parameter that has been used to predict adverse outcomes in different clinical settings. The prognostic value of SII, an innovative biomarker of inflammation, in non-valvular atrial fibrillation (NVAF) patients has not been assessed. The aim of this study was to evaluate the prognostic value of SII in NVAF patients who were under direct oral anticoagulant (DOAC) medication.
Methods: A total of 467 patients with NVAF treated with DOACs from 2018 to 2021 were retrospectively enrolled in this cohort study. Demographics, medication, and outcome data were collected for each patient. SII was calculated from complete blood counts as the ratio of neutrophil-to-lymphocyte count multiplied by the platelet count. The primary outcome was major adverse events (MAEs), which include major bleeding, stroke, and death.
Results: Logistic regression analyses showed that the SII score was an important predictor of outcomes in NVAF patients.
Conclusion: The SII may be a successful, non-invasive, and cost-effective parameter for predicting bleeding and stroke in patients with NVAF. It may be used as a useful risk stratification tool for these patients.
Keywords: systemic immune-inflammation index, atrial fibrillation, direct oral anticoagulants
Submitted: June 15, 2025; Accepted: October 13, 2025; Published: February 20, 2026
Cardiovasc J Afr 2025; 37: 20-26
Volume 37, Issue 1
DOI Citation Reference: dx.doi.org/10.5830/CVJA-2025-107
Uskudar University Faculty of Medicine, Department of Cardiology
Kahraman Cosansu

Derince Education and Research Hospital, Department of Cardiology, University of Health Sciences
Sabiye Yilmaz

Antalya Education and Research Hospital, Department of Cardiology, University of Health Sciences
Cagin Mustafa Ureyen

Ankara Education and Research Hospital, Department of Cardiology, University of Health Sciences
Mustafa Gokhan Vural

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