Investigation of the prediction of the systemic immune-inflammatory index in patients with peripheral artery disease

Peripheral arterial diseases; It is among the important factors that cause an increase in the morbidity and mortality rates due to cardiovascular diseases all over the world. Peripheral arterial disease is frequently associated with ischemic heart diseases and cerebrovascular diseases, since the underlying pathological cause is atherosclerosis. Lots of research; revealed that the systemic immune-inflammation index has an important role in the initiation, progression and follow-up of atherosclerosis. It has been repeatedly shown that neutrophils, lymphocytes and platelets are cells that have important roles in systemic immune-inflammation, which is held responsible for the formation of atherosclerosis. The study included 170 patients who applied to the cardiology outpatient clinic of Fırat University Hospital with claudication between January 2022 and April 2022 and were diagnosed with peripheral artery disease after angiographic imaging. The patients were divided into two groups according to their angiography scores as the prevalence of atherosclerosis was low (n=90) and the prevalence of atherosclerosis was high (n=80). 100 healthy volunteers with similar demographic characteristics, who did not have active complaints and who applied to the outpatient clinic for control purposes were included in the study as the control group. Laboratory results of the patients were analyzed retrospectively. Demographic characteristics of the patients (age, gender, smoking, hypertension, diyabetes, chronic kidney disease, hyperlipidemia) were questioned and reported in all three groups. There was a statistically significant difference between the groups in terms of low density lipoprotein levels, high sensitive C Reactive Protein levels, neutrophil / lymphocyte ratio and systemic immune inflammation index. It has been shown that there is a positive correlation between the systemic immune inflammation index and the angiography score in peripheral arterial patients. The presence of diffuse atherosclerosis in peripheral arterial patients after univariate regression analysis and multiple linear regression analysis; It was observed that neutrophil / lymphocyte ratio and systemic immune inflammation index parameters were predictive. To predict high angiographic score in all subjects included in the study population after receiver operating characteristic curve analysis, the threshold for systemic immune inflammation index at admission was 1098 with 72% sensitivity and 64% specificity (area under the curve 0.790; 95%CI:0.720- 0.860; p<0.001). It has been demonstrated that the neutrophil / lymphocyte ratio and systemic immune inflammatory index parameters, which can be simply calculated with the data obtained from the complete blood count and do not require additional costs, can contribute to the diagnosis of peripheral artery disease and to predict the severity in terms of the extent of atherosclerosis. However, this relationship needs to be confirmed by future studies with larger populations and prospective studies in this area. Keywords: Systemic Immune-inflammation Index, Neutrophil / lymphocyte ratio, Peripheral artery disease, Predictiveness.