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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.

Sec. Coronary Artery Disease

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1652379

This article is part of the Research TopicPrognostic Value of Inflammatory and Thrombotic Biomarkers in Acute Coronary SyndromeView all 6 articles

The Role of Systemic Inflammatory Response Index in Predicting Myocardial Infarction in Patients with Unstable Angina

Provisionally accepted
Zhengwen  YangZhengwen YangShuiquan  LiShuiquan LiTianlu  WangTianlu WangXiangyu  ZhaoXiangyu ZhaoFang  WangFang WangXueqian  ZhangXueqian ZhangYangang  ChenYangang Chen*
  • Wuwei Liangzhou Hospital, Wuwei, China

The final, formatted version of the article will be published soon.

Background: Unstable angina (UA) is a high-risk presentation of acute coronary syndrome (ACS) that can rapidly progress to myocardial infarction (MI) if not identified and managed promptly. Inflammation plays a key role in plaque instability and thrombotic events, making inflammatory biomarkers useful tools for early risk assessment. The Systemic Inflammatory Response Index (SIRI), derived from peripheral blood cell counts, has emerged as a novel marker of systemic inflammation, but its prognostic utility in UA remains underexplored. Objective: The purpose of this study was to investigate the role of the Systemic Inflammatory Response Index (SIRI) in predicting myocardial infarction and major adverse cardiovascular events (MACE) in patients presenting with unstable angina. Methods: This retrospective observational study included 129 adult patients diagnosed with unstable angina and admitted to a tertiary care center. SIRI was calculated as (neutrophil count × monocyte count) / lymphocyte count using laboratory values obtained at admission. Patients were stratified into low and high SIRI groups based on a cutoff derived from ROC analysis. Clinical, laboratory, and angiographic data were collected, and outcomes including MI and MACE (composite of MI, cardiovascular death, stroke, and urgent revascularization) were assessed. ROC curves, logistic regression, and Kaplan–Meier analysis were used for statistical evaluation. Results: Patients with high SIRI levels had significantly higher rates of myocardial infarction (38% vs. 10%, p < 0.001) and MACE (17.1% vs. 6.1%, p < 0.01). SIRI demonstrated excellent predictive performance for MI with an AUC of 0.858, sensitivity of 90%, and specificity of 94%. Multivariate logistic regression confirmed SIRI as an independent predictor of MI (OR = 2.15, 95% CI: 1.25–3.71). Conclusion: SIRI is a simple, accessible, and powerful inflammatory marker that independently predicts myocardial infarction and MACE in patients with unstable angina. Its integration into early risk assessment may enhance clinical decision-making and improve patient outcomes.

Keywords: systemic inflammatory response index, Unstable angina, Myocardial Infarction, Inflammation, risk stratification

Received: 23 Jun 2025; Accepted: 15 Sep 2025.

Copyright: © 2025 Yang, Li, Wang, Zhao, Wang, Zhang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yangang Chen, chenyangang318@163.com

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