Systemic Inflammation Response Index as a Predictor of Stroke Risk in Elderly Patients with Hypertension: A Cohort Study

医学 冲程(发动机) 内科学 炎症 全身炎症 队列研究 队列 中风风险 索引(排版) 风险因素 心脏病学 缺血性中风 机械工程 工程类 缺血 万维网 计算机科学
作者
Xintian Cai,Shuaiwei Song,Junli Hu,Lei Wang,Shen Di,Qing Zhu,Wenbo Yang,Qin Luo,Jing Hong,Nanfang Li
出处
期刊:Journal of Inflammation Research [Dove Medical Press]
卷期号:Volume 16: 4821-4832 被引量:22
标识
DOI:10.2147/jir.s433190
摘要

Objective: This study aimed to evaluate the relationship between the systemic inflammation response index (SIRI) and the risk of stroke and its subtypes in elderly patients with hypertension and to explore its predictive accuracy and any potential effect modifiers. Methods: The study included 4749 participants with no history of stroke at baseline. Cox regression was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CIs). Interaction tests and subgroup analyses were conducted. The predictive performance of various inflammatory indicators for stroke was compared using the area under the curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: During a median follow-up period of 3.2 years, 640 strokes were recorded, of which 526 were ischemic and the remainder hemorrhagic. After adjustment for confounders, compared to the reference group, the HRs (95% CI) of stroke were 1.28 (95% CI, 1.01– 1.64) and 1.46 (95% CI, 1.14– 1.88) for participants in the second and third tertiles, respectively. We observed interactions between SIRI and homocysteine levels (< 15 vs. ≥ 15 μmol/L) (p for interaction = 0.014) on ischemic stroke risk. Furthermore, the AUC, NRI, and IDI analyses demonstrated that SIRI exhibited better predictive value for stroke risk when compared to other indicators. Similar results were observed for both ischemic and hemorrhagic strokes. Conclusion: Elevated SIRI levels were significantly associated with the risk of stroke and its subtypes in elderly patients with hypertension, suggesting its potential as a promising indicator for stroke risk in this population. However, larger prospective studies are needed to confirm these findings. Keywords: systemic inflammation response index, stroke, elderly, hypertension, inflammation, cohort study
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