Study on predictive value of systemic inflammatory response index for severe coronary artery calcification in patients with hypertension

HE Shao-dong; WANG Le-xuan; LI Xin-ran; SU Li-chen; LIU Rui-feng

doi:10.3969/j.issn.1672-5301.2025.11.006

Abstract：Objective To explore the correlation between the systemic inflammatory response index(SIRI)and severe coronary artery calcification in patients with hypertension and its diagnostic value.Methods 580 patients with hypertension who were treated in Beijing Friendship Hospital from August 2015 to December 2023 were selected.The baseline clinical data and laboratory test results of the patients were collected.They were divided into the severe coronary artery calcification group(n=316)and non-severe coronary artery calcification group(n=264)based on whether severe coronary artery calcification(coronary artery calcium score>400)occurred.Three Logistic regression models were constructed by stepwise adjustment of confounding factors:Model 1(unadjusted),Model 2(adjusted for age and gender)and Model 3(further adjusted for other clinical covariates on the basis of Model 2).Logistic regression analysis was conducted by taking SIRI as a continuous variable and a categorical variable(divided into T1,T2 and T3 groups according to the SIRI tertiles)to explore the relationship between SIRI and severe coronary artery calcification.The potential nonlinear relationship was further explored through restricted cubic splines(RCS),and the performance indicators of SIRI in predicting severe coronary artery calcification were calculated.Results The baseline data showed that the SIRI level in the severe calcification group was significantly higher than that in the non-severe calcification group[0.74(0.50,1.12)vs.0.92(0.64,1.34),P<0.001].Logistic regression results indicated that in the three stepwise adjusted models,SIRI,whether as a continuous variable or a categorical variable,was the risk factor for severe coronary artery calcification(Model 1:OR=1.68,95%CI 1.27-2.23,P<0.001;Model 2:OR=1.66,95%CI 1.20-2.22,P<0.001;Model 3,OR=1.63,95%CI 1.20-2.22,P=0.002),and the risk of severe coronary artery calcification gradually increased with the increase of SIRI level.The risk of severe coronary artery calcification in the high SIRI value group(T3)was 2.34 times that in the low SIRI value group(T1).RCS analysis further confirmed that SIRI level was linearly and positively correlated with the risk of severe coronary artery calcification(nonlinear test P=0.172,total effect P=0.004).Taking the SIRI value when the odds ratio=1 as the cut-off value,the cut-off value of the three models was 0.821.When SIRI>0.821,the risk of severe coronary artery calcification increased with the increase of SIRI value.The predictive performance of this cut-off value was as follows:sensitivity 56.01%,specificity 57.20%,positive predictive value 61.03%,negative predictive value 52.07%,and Youden index 0.1321.Conclusion There is a positive linear relationship between the SIRI and severe coronary artery calcification in patients with hypertension,and it is a potential indicator for predicting severe calcification.