Evaluation of the prognostic value of systemic inflammation indexes in patients diagnosed with acute coronary syndrome in the emergency department

Background: Cardiovascular diseases progress through inflammation. The aim of this study was to determine the prognostic value of systemic inflammation markers in predicting mortality in patients with acute coronary syndrome (ACS). Methods: This retrospective cross-sectional study included patients who presented at the Emergency Department (ED) with ACS (ST segment elevation myocardial infarction (STEMI)Myocardial infarction without ST segment elevation (NSTEMI)). Patients who met the study inclusion criteria were selected retrospectively and data were retrieved from the hospital's automated records system. Systemic inflammatory indexes, including the Systemic inflammation response index (SIRI), Systemic immune-inflammation index (SII) and Aggregate index of systemic inflammation (AISI) were calculated. The patients were grouped according to mortality status and were examined in two groups as STEMI and NSTEMI. Results: The study included 509 patients, comprising 77.2% males and 22.8% females with a mean age of 57.7 years. STEMI was diagnosed in 309 patients and NSTEMI in 200. The most common comorbidities were hypertension in 27.4% of cases, coronary artery disease in 19.4%, and diabetes mellitus in 16.8%. Mortality occurred in 14.3% of the cases. The mean age was found to be significantly higher in the NSTEMI group than in the STEMI group (p < 0.05). The neutrophil value, SII, SIRI and AISI values were significantly higher in the NSTEMI group than in the STEMI group (p < 0.05 for all). The Neutrophil to Lymphocyte ratio (NLR), SIRI, SII and AISI values were also markedly higher in the exitus patient group than in the survivors group (p < 0.05 for all). The multivariate regression analysis results showed that the NLR, SIRI and AISI values had an independent and significant impact on distinguishing survivors from deceased the patients (p < 0.05). Conclusions: Systemic inflammation indexes were found to be significant predictors of mortality in patients with ACS.