Systemic Immune-Inflammation Index and Coronary Microvascular Dysfunction in Patients with Non-Obstructive Coronary Arteries
DOI:
https://doi.org/10.53350/pjmhs02026207.5Keywords:
coronary microvascular dysfunction; systemic immune-inflammation index; non-obstructive coronary arteries; coronary flow reserve; microvascular resistance; inflammationAbstract
Background: Coronary microvascular dysfunction contributes to ischaemic symptoms in individuals with non-obstructive coronary arteries. Systemic inflammation might lead to endothelial dysfunction and irregular coronary microvascular resistance. The systemic immune-inflammation index is an indicator obtained from the numbers of neutrophils, lymphocytes, and platelets.
Aim: To assess the correlation between the systemic immune-inflammation index and coronary microvascular dysfunction in individuals with non-obstructive coronary arteries.
Methods: This cross-sectional investigation included 150 individuals receiving coronary angiography at Mayo Hospital Lahore between June 2024 and June 2025. Individuals suffering from obstructive coronary artery disease, acute coronary syndrome, ongoing infections, inflammatory conditions, cancer, or diminished left ventricular ejection fraction were omitted. Coronary microvascular dysfunction was characterised by a coronary flow reserve of less than 2.0, a microvascular resistance score of 25 or higher, or both criteria. The systemic immune-inflammation index was determined by multiplying the platelet count by the neutrophil count and then dividing by the lymphocyte count.
Results: Coronary microvascular impairment was detected in 62 individuals (41.3%). The median systemic immune-inflammation score was elevated in individuals exhibiting dysfunction compared to those with intact microvascular function (821 vs 487; p<0.001). The index exhibited a negative correlation with coronary flow reserve (r=−0.49) and a positive correlation with microvascular resistance (r=0.53), both p<0.001. Following multivariable correction, every 100-unit increment continued to be independently linked to dysfunction (adjusted odds ratio 1.18; 95% confidence range 1.09–1.28). A threshold of 620 demonstrated 80.6% sensitivity and 73.9% specificity.
Conclusion: The systemic immune-inflammation score was independently linked to coronary microvascular dysfunction and might aid in risk classification for individuals with non-obstructive coronary arteries.
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Copyright (c) 2026 Benazeer Mikrani, Attaullah Khan Niazi, Amna Batool Jafri, Muhammad Asif Farooqi, Haris Mahmood, Zargham Yaqub, Warda Gul, Alisha Afzal
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