Association between systemic inflammation response index and risk of major adverse cardiovascular events in adults with and without metabolic syndrome: a prospective cohort study in Shanghai, Pudong.
To investigate the prognostic value of the systemic inflammation response index (SIRI) for major adverse cardiovascular events (MACE) among adults with metabolic syndrome (MS), and to determine whether MS status modifies the association between SIRI and incident MACE.
This prospective cohort study enrolled 3,198 participants from Pudong New Area, Shanghai, with a median follow-up of 43 months. Baseline characteristics were compared across SIRI quartiles stratified by MS status. Multivariable Cox proportional hazards regression models were constructed to evaluate the independent association between SIRI and MACE. Restricted cubic spline (RCS) analysis was performed to examine the dose-response relationship. Interaction analyses were conducted to assess effect modification by key metabolic components.
Of 3,198 participants, 1,318 had MS and 1,880 did not. Higher SIRI quartiles were associated with unfavorable metabolic profiles in both groups. Compared with non-MS participants in the lowest SIRI quartile, participants with MS in the highest SIRI quartile exhibited the greatest risk of MACE (HR = 2.33, 95% CI: 1.64-3.30, P < 0.001). Among participants with MS, the highest quartile demonstrated a 38% elevated risk compared with the lowest quartile (HR = 1.38, 95% CI: 1.08-1.77, P = 0.01). RCS analysis indicated a linear positive association between SIRI and MACE risk among participants with MS (P for overall association = 0.02). A significant non-linear interaction was identified between SIRI and fasting plasma glucose (P for interaction = 0.04).
Elevated SIRI is independently associated with an increased risk of incident MACE, and MS status significantly modifies this association. SIRI represents a promising and readily available biomarker for cardiovascular risk stratification, especially among individuals with MS. Combined interventions targeting systemic inflammation and glycemic control may reduce the risk of MACE in this high-risk population.
This prospective cohort study enrolled 3,198 participants from Pudong New Area, Shanghai, with a median follow-up of 43 months. Baseline characteristics were compared across SIRI quartiles stratified by MS status. Multivariable Cox proportional hazards regression models were constructed to evaluate the independent association between SIRI and MACE. Restricted cubic spline (RCS) analysis was performed to examine the dose-response relationship. Interaction analyses were conducted to assess effect modification by key metabolic components.
Of 3,198 participants, 1,318 had MS and 1,880 did not. Higher SIRI quartiles were associated with unfavorable metabolic profiles in both groups. Compared with non-MS participants in the lowest SIRI quartile, participants with MS in the highest SIRI quartile exhibited the greatest risk of MACE (HR = 2.33, 95% CI: 1.64-3.30, P < 0.001). Among participants with MS, the highest quartile demonstrated a 38% elevated risk compared with the lowest quartile (HR = 1.38, 95% CI: 1.08-1.77, P = 0.01). RCS analysis indicated a linear positive association between SIRI and MACE risk among participants with MS (P for overall association = 0.02). A significant non-linear interaction was identified between SIRI and fasting plasma glucose (P for interaction = 0.04).
Elevated SIRI is independently associated with an increased risk of incident MACE, and MS status significantly modifies this association. SIRI represents a promising and readily available biomarker for cardiovascular risk stratification, especially among individuals with MS. Combined interventions targeting systemic inflammation and glycemic control may reduce the risk of MACE in this high-risk population.
Authors
Meng Meng, Ke Ke, Wang Wang, Qiu Qiu, Liu Liu, Gao Gao, Song Song, Liu Liu, Xu Xu, Wu Wu, Huang Huang, Qian Qian, Song Song, Ruan Ruan, Wu Wu, Zhou Zhou
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