Systemic immune-inflammation index: A novel marker for predicting response to cardiac resynchronization therapy in patients with heart failure

Abstract

Aim: To investigate the utility of systemic immune-inflammation index (SII) in predicting response to cardiac resynchronization therapy (CRT) among patients with heart failure (HF).

Method: A total of 78 patients with HF who underwent CRT device implantation were included in this 6-month follow up study. Data on laboratory findings including complete blood count, blood biochemistry and SII as well as the transthoracic echocardiography findings were recorded at baseline prior to CRT device implantation and 6 months after CRT.

Results: The criteria for response to CRT including improvements in New York Heart Association (NYHA), left ventricular end-systolic volume (LVESV) (decreased by ≥15%) and ejection fraction (EF) (increased by≥10%) were met by 73.1%, 65.4% and 69.2% of patients, respectively. In patients with decreased vs. increased SII values during 6-month therapy, the likelihood of meeting LVESV (84.3 vs. 15.7%, p<0.001), EF (81.5 vs. 18.5%, p<0.001) and NYHA (77.2 vs. 22.8%, p<0.001) response criteria for successful CRT were significantly higher. Multivariate analysis revealed that decrease in SII (OR 0.982, 95% CI: 0.970 to 0.995, p=0.006) and TAPSE (OR 0.602, 95% CI. 0.396 to 0.916, p=0.018) during treatment as the only significant determinants of presence of response to CRT in heart failure (HF) patients.

Conclusions: Our findings seem to indicate the favorable utility of SII, as a non-invasive readily available marker, in predicting response to CRT and thus enabling a beneficial reverse remodeling process via timely implementation of advanced treatments in HF patients.