ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1666658
Association between systemic inflammation response index and atrial fibrillation in chronic obstructive pulmonary disease: a multicenter cross-sectional study
Provisionally accepted
- 1People's Hospital of Quzhou, Quzhou, China
- 2The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- 3Gansu Provincial Center for Disease Prevention and Control, Lanzhou, China
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Background: Systemic inflammation plays a critical role in the pathogenesis of both chronic obstructive pulmonary disease (COPD) and atrial fibrillation (AF). As an emerging biomarker reflecting systemic inflammatory status, the association between the systemic inflammation response index (SIRI) and the risk of AF in patients with COPD remains unclear. Therefore, this study aimed to investigate the association between SIRI levels and the risk of AF in patients with COPD.In this multicenter cross-sectional study, we enrolled 1,133 hospitalized COPD patients from May 2021 to May 2024 at the First Affiliated Hospital of Wenzhou Medical University and Quzhou People's Hospital. Patients were categorized into four groups based on SIRI quartiles. We used multivariate logistic regression, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curves to evaluate the association between SIRI and AF risk. Subgroup, interaction, and sensitivity analyses were conducted to assess robustness and effect modification.Results: Among the study population, 225 patients (19.85%) had AF. After full adjustment, this cross-sectional analysis demonstrates that each 1-unit increase in SIRI was associated with a 4.6% higher AF risk (OR = 1.046, 95% CI: 1.018-1.075, p = 0.002). Patients in the highest SIRI quartile had a 116.2% increased risk compared to those in the lowest quartile (OR = 2.162, 95% CI: 1.325-3.527, p = 0.002). RCS analysis revealed a significant linear dose-response relationship between SIRI and AF risk. ROC analysis showed that combining SIRI with conventional risk factors improved predictive accuracy for AF (AUC = 0.818, 95% CI: 0.787-0.848, p < 0.001). A significant interaction was observed among smokers (interaction p = 0.006), and results remained robust in sensitivity analyses.Elevated SIRI levels are independently associated with an increased risk of AF in patients with COPD, especially among smokers. As a simple and readily accessible biomarker of low-grade systemic inflammation, SIRI may serve as an effective tool for assessing the risk of atrial fibrillation in patients with COPD.
Keywords: systemic inflammation response index, chronic obstructive pulmonary disease, Atrial Fibrillation, risk prediction, Cross-sectional study
Received: 15 Jul 2025; Accepted: 13 Aug 2025.
Copyright: © 2025 Xu, Li, Yang, Zheng, Zhu, Chen and Zhao. 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:
Lijuan Chen, Gansu Provincial Center for Disease Prevention and Control, Lanzhou, China
Hongjun Zhao, People's Hospital of Quzhou, Quzhou, China
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