Yalçın Avcı1, Mustafa Duran2, Ali Rıza Demir1, Gökhan Demirci1, Ömer Taşbulak1, Arda Güler1, Ahmet Arif Yalçın1, Sezgin Atmaca1, Mehmet Ertürk1

1Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
2Clinic of Cardiology, Konya City Hospital, Konya, Türkiye

Keywords: Endovascular procedures; inflammation; peripheral arterial disease


Introduction: Endovascular interventions have been increasingly used for the treatment of patients suffering from below-the-knee (BTK) ischemic lesions. Yet, there is a paucity of data regarding long-term adverse events in patients with critical limb ischemia (CLI) undergoing endovascular revascularization for BTK lesions. Recently introduced systemic immune-inflammation index (SII) is a reliable indicator of poor outcomes in various cardiovascular conditions. Herein, we aimed to investigate the prognostic role of the SII on mortality in patients with CLI undergoing endovascular revascularization for BTK lesions.

Patients and Methods: The records of 112 patients with symptomatic CLI undergoing endovascular revascularization for BTK lesions between January 2015 and December 2019 were analyzed. Patients were divided into groups with low and high SII values based on an SII cut-off value derived from a ROC analysis. For each group, procedural details and follow-up outcomes were analyzed.

Results: The mean follow-up time was 40.3 ± 19.9 months. According to our data, patients with high SII values had higher rates of mortality compared to patients with low SII values (65.2% vs 30.3%, p< 0.001). To determine the SII cut-off value for predicting mortality, the ROC curve was drawn, and the best cut-off value was determined as 966 by using the Youden index, (AUC= 0.658, 95% CI= 0.556-0.760, p= 0.004). Cox multivariate regression analysis also identified the SII score as an independent predictor of mortality.

Conclusion: SII is an independent predictor of mortality, especially among patients with CLI who underwent endovascular revascularization for BTK lesions.

Cite this article as: Avcı Y, Duran M, Demir AR, Demirci G, Taşbulak Ö, Güler A, et al. Association between systemic immune-inflammation index and long-term mortality in patients with critical limb-threatening ischemia undergoing endovascular therapy below the knee. Koşuyolu Heart J 2022;25(3):262-269.

Ethics Committee Approval

The approval for this study was obtained from İstanbul Mehmet Akif Ersoy Thoraric and Cardiovascular Surgery Training and Research Hospital Clinical Research Ethics Committee (Decision no: 2022.06.40, Date: 02.08.2022).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - YA, MD; Analysis/Interpretation - YA, ÖT; Data Collection - YA, SA, GD; Writing - YA, AG; Critical Revision - AY, ME; Final Approval - ME; Statistical Analysis - AD; Overall Responsibility - YA.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declare that this study has received no financial support.