WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Dr. Hasan Ahmed Fadaam, Dr. Khulood Abed Reman

ABSTRACT

Background: Major adverse cardiovascular events (MACE) remain an important cause of morbidity and mortality following percutaneous coronary intervention (PCI). The Systemic Immune-Inflammation Index (SII) and Residual SYNTAX Score (rSS) have emerged as promising prognostic markers in patients undergoing PCI. Aims: To evaluate the predictive value of the Systemic Immune-Inflammation Index and Residual SYNTAX Score for major adverse cardiovascular events following percutaneous coronary intervention at Al-Kindy Teaching Hospital, Baghdad. Patients and Methods: This retrospective cohort study included 113 patients who underwent PCI at Al-Kindy Teaching Hospital between February 2023 and May 2026. Demographic, clinical, laboratory, angiographic, and procedural data were collected. The Systemic Immune-Inflammation Index was calculated using platelet, neutrophil, and lymphocyte counts, while the Residual SYNTAX Score was determined after PCI. Major adverse cardiovascular events, including cardiac death, nonfatal myocardial infarction, stroke, repeat revascularization, and hospitalization for heart failure, were recorded during follow-up. Receiver operating characteristic curve analysis and multivariate logistic regression analysis were performed to evaluate the predictive value of the studied parameters. Results: The mean age of the study population was 59.3 ± 10.8 years, and 71.7% of patients were male. Major adverse cardiovascular events occurred in 24 patients (21.2%) during follow-up. Patients who developed MACE had significantly higher mean SII values than those without adverse outcomes (1124.3 ± 402.1 versus 729.8 ± 285.6, P < 0.001). Similarly, the residual SYNTAX score was significantly higher among patients with MACE (9.1 ± 4.8 versus 4.9 ± 3.2, P < 0.001). Receiver operating characteristic analysis demonstrated that SII predicted MACE with an area under the curve (AUC) of 0.78, whereas residual SYNTAX score demonstrated an AUC of 0.82. The combined model of SII and residual SYNTAX score yielded the highest predictive accuracy with an AUC of 0.87. Multivariate logistic regression analysis identified elevated SII (OR = 2.84, 95% CI: 1.45–5.56, P = 0.002) and higher residual SYNTAX score (OR = 3.27, 95% CI: 1.72–6.23, P < 0.001) as independent predictors of major adverse cardiovascular events. Conclusions: The Systemic Immune-Inflammation Index and Residual SYNTAX Score are significant independent predictors of major adverse cardiovascular events following percutaneous coronary intervention. The combined use of these parameters provides superior prognostic accuracy compared with either marker alone and may represent a valuable strategy for comprehensive cardiovascular risk stratification in patients undergoing PCI.

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