eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 20
Original paper

The effect of the systemic immune–inflammatory index on the no-reflow phenomenon in patients undergoing saphenous vein intervention

Ahmet Can Cakmak
İbrahim Kocayigit
Perihan Varım
Betül Sarıbıyık Çakmak
Yusuf Can
Mehmet Bülent Vatan

  1. Department of Cardiology, Sakarya University Education and Research Hospital, Sakarya, Turkey
  2. Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
  3. Heart and Arrhythmia Centre, Focus Tıp Merkezi, Sakarya, Turkey
Adv Interv Cardiol 2024; 20, 2 (76): 148–156
Online publish date: 2024/06/04
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The systemic immune inflammation index (SII), based on lymphocyte, neutrophil, and platelet counts, has been shown to be an independent indicator of no-reflow phenomenon during percutaneous intervention. However, the relationship between SII and no-reflow phenomenon (NRP) that develops after the procedure of saphenous vein grafts is unknown.

In this study, we aimed to investigate the relationship between no-reflow phenomenon and SII during percutaneous intervention on saphenous vein grafts.

Material and methods:
A total of 133 patients who underwent percutaneous intervention for saphenous vein grafts due to acute coronary syndrome between 2019 and 2022 were included in this study. The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of SII to predict the no-reflow. The multivariate regression was used to analyse the correlation between no-reflow and SII.

The median value of SII was significantly higher in patients with no-reflow in comparison with normal reperfusion (543 (447, 717) vs. 861 (642, 1272), p < 0.001). The optimal threshold for SII in predicting the no-reflow phenomenon was 613, with sensitivity and specificity of 84% and 66%, respectively. The area under the ROC curve (AUC) was 0.80 (95% CI: 0.73–0.89, p < 0.001). In multivariate analysis, SII ≥ 613 showed an independent predictive value for the no-reflow (OR = 4.02, 95% CI: 1.40–11.57, p < 0.001).

Our results showed that high SII levels were independently associated with the development of no-reflow phenomenon in patients presenting with acute coronary syndrome and undergoing percutaneous intervention to the SVG.


no-reflow phenomenon, systemic immune–inflammatory index, saphenous vein intervention

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