Data Sheet 1_Diagnostic and prognostic value of systemic immune-inflammation index for heart failure: a systematic review and meta-analysis.docx

BackgroundIncreasing evidence has indicated the potential correlation between Systemic Immune-Inflammation Index (SII) and the incidence and prognosis of patients with heart failure (HF). However, the association remains unraveled in the existing research.
MethodsA literature search was systematically conducted across PubMed, Embase, Web of Science, and the Cochrane Library from their respective inceptions to July 2024, aiming to identify studies investigating the association between SII and both the incidence and clinical outcomes of HF patients. The primary outcomes included incidence and mortality rates, which were assessed using risk ratios (RR) and corresponding 95% confidence intervals (CIs). To assess the robustness of the findings and to identify potential sources of heterogeneity, sensitivity analyses and subgroup analyses were conducted. Meta-analyses were carried out using Review Manager (v5.4) and STATA (v15.0).
ResultsFifteen studies comprising 77,917 patients were included. The pooled data demonstrated no significant association between SII and the incidence of HF (RR = 1.22, 95%CI: 0.92–1.62; p = 0.16). However, a significant correlation was identified between elevated SII and increased mortality risk (RR = 1.44, 95%CI: 1.29–1.61; p < 0.00001). Furthermore, subgroup analyses revealed the association between SII and mortality in patients with HF was not influenced by sample size, age, country, study design, or ejection fraction. In contrast, the association between SII and incidence of HF was affected by country, while no significant effect was observed in the other subgroups.
ConclusionAs a reliable biomarker, SII exhibits significant efficacy in prognostic evaluation for HF patients and provides valuable insights to inform clinical decision-making in the HF population.
Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/myprospero, PROSPERO CRD42024582003.

背景：越来越多的证据表明，全身免疫炎症指数（Systemic Immune-Inflammation Index, SII）与心力衰竭（heart failure, HF）患者的发病及预后存在潜在关联，但现有研究尚未明确二者间的具体关联。
方法：本研究系统检索了PubMed、Embase、Web of Science及Cochrane Library自建库至2024年7月的相关文献，旨在筛选探讨SII与心力衰竭患者发病情况及临床结局关联的研究。本研究的主要结局指标为发病率与死亡率，采用风险比（risk ratio, RR）及对应95%置信区间（confidence interval, CI）进行效应量评估。为评估研究结果的稳健性并明确潜在异质性来源，本研究开展了敏感性分析与亚组分析。数据分析采用Review Manager（版本5.4）及STATA（版本15.0）完成荟萃分析。
结果：本研究共纳入15项研究，涉及77917名患者。合并分析结果显示，SII水平与心力衰竭发病率无显著统计学关联（RR=1.22，95%CI：0.92–1.62；P=0.16）。但较高的SII水平与心力衰竭患者的死亡风险升高存在显著统计学相关性（RR=1.44，95%CI：1.29–1.61；P<0.00001）。此外，亚组分析显示，SII与心力衰竭患者死亡率的关联不受样本量、患者年龄、研究所在国家、研究设计或射血分数的影响。与之相反，SII与心力衰竭发病率的关联受研究所在国家因素的影响，其余亚组未观察到显著统计学效应。
结论：作为一项可靠的生物标志物，全身免疫炎症指数在心力衰竭患者的预后评估中具有显著应用价值，可为心力衰竭人群的临床决策提供有价值的参考依据。
系统评价注册：https://www.crd.york.ac.uk/PROSPERO/myprospero，PROSPERO CRD42024582003。