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Background <p>The combined impact of the systemic immune-inflammation index (SII) and the triglyceride-glucose index (TyG) on short- and long-term outcomes in patients with coronary heart disease (CHD) remains unclear. This study aimed to investigate the association between the SII combined with the TyG index and mortality risk in CHD patients.</p> Methods <p>This study included 970 CHD patients from the MIMIC-IV database. Participants were divided into four quartiles based on median SII and TyG values: T1 (low SII and low TyG), T2 (low SII and high TyG), T3 (high SII and low TyG), and T4 (high SII and high TyG). The combined impact of these indices on CHD patient prognosis was explored using Cox proportional hazards models, Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and subgroup analyses.</p> Results <p>Compared with the T1 group, the T4 group showed a significantly increased risk of mortality. Multivariate Cox regression analysis revealed the highest 30-day (HR = 2.446, 95% CI 1.366–4.382, <i>p</i> = 0.003) and 1-year (HR = 1.586, 95% CI 1.054–2.387, <i>p</i> = 0.027) mortality risks in the T4 group. ROC curves further confirmed that the combined SII-TyG index demonstrated superior predictive capability for both short-term (AUC = 0.728, 95% CI 0.677–0.778) and long-term (AUC = 0.742, 95% CI 0.703–0.780) outcomes in CHD patients compared to the SII or TyG index alone. Subgroup analyses indicated that the predictive value of the combined index demonstrated considerable universality across different clinical strata. Furthermore, incorporating the combined index into baseline models moderately improved mortality prediction performance. Similarly, a cohort of 1,621 CHD patients from the eICU2.0 database yielded comparable findings: elevated SII and TyG indices correlated with increased in-hospital mortality risk (T4 HR = 3.378, 95% CI 1.716–6.649, <i>p</i> &lt; 0.001), and ROC curve analysis confirmed that combined assessment demonstrated the highest predictive efficacy (AUC = 0.800, 95% CI 0.760–0.840).</p> Conclusion <p>In summary, the combined assessment of SII and TyG indices assists clinicians in identifying high-risk populations and improving outcomes for patients with CHD.</p>

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Study of the prognostic value of the systemic immune-inflammation index combined with the triglyceride-glucose index in coronary heart disease: a retrospective study based on the MIMIC database

  • 期刊论文

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  • 发表日期：

    2026年2月4日

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  • Chen-yang Wu,
  • Yu-qin Zhan,
  • Yu-bin Shen,
  • Ting-shan Yu,
  • Ya-hui Ding

摘要

Background

The combined impact of the systemic immune-inflammation index (SII) and the triglyceride-glucose index (TyG) on short- and long-term outcomes in patients with coronary heart disease (CHD) remains unclear. This study aimed to investigate the association between the SII combined with the TyG index and mortality risk in CHD patients.

Methods

This study included 970 CHD patients from the MIMIC-IV database. Participants were divided into four quartiles based on median SII and TyG values: T1 (low SII and low TyG), T2 (low SII and high TyG), T3 (high SII and low TyG), and T4 (high SII and high TyG). The combined impact of these indices on CHD patient prognosis was explored using Cox proportional hazards models, Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and subgroup analyses.

Results

Compared with the T1 group, the T4 group showed a significantly increased risk of mortality. Multivariate Cox regression analysis revealed the highest 30-day (HR = 2.446, 95% CI 1.366–4.382, p = 0.003) and 1-year (HR = 1.586, 95% CI 1.054–2.387, p = 0.027) mortality risks in the T4 group. ROC curves further confirmed that the combined SII-TyG index demonstrated superior predictive capability for both short-term (AUC = 0.728, 95% CI 0.677–0.778) and long-term (AUC = 0.742, 95% CI 0.703–0.780) outcomes in CHD patients compared to the SII or TyG index alone. Subgroup analyses indicated that the predictive value of the combined index demonstrated considerable universality across different clinical strata. Furthermore, incorporating the combined index into baseline models moderately improved mortality prediction performance. Similarly, a cohort of 1,621 CHD patients from the eICU2.0 database yielded comparable findings: elevated SII and TyG indices correlated with increased in-hospital mortality risk (T4 HR = 3.378, 95% CI 1.716–6.649, p < 0.001), and ROC curve analysis confirmed that combined assessment demonstrated the highest predictive efficacy (AUC = 0.800, 95% CI 0.760–0.840).

Conclusion

In summary, the combined assessment of SII and TyG indices assists clinicians in identifying high-risk populations and improving outcomes for patients with CHD.