Nonlinear relationship and predictive value of systemic immune-inflammation index for atrial fibrillation recurrence after catheter ablation in hypertensive patients
Zixi Zhang, Shunyi Li, Tao Tu, Chaoshuo Liu, Yongguo Dai, Cancan Wang, Qiuzhen Lin, Chan Liu, Yichao Xiao, Qiming Liu
Abstract
BACKGROUND: Atrial fibrillation (AF) is a prevalent arrhythmia in hypertensive patients and significantly increases mortality. Chronic inflammation plays a critical role in the pathophysiology of AF. OBJECTIVE: This study aimed to evaluate the prognostic value of systemic immune-inflammation index (SII) in predicting AF recurrence after catheter ablation in hypertensive patients. METHODS: This retrospective cohort study included 418 hypertensive patients with paroxysmal AF who underwent catheter ablation between January 2019 and January 2023. Cox proportional hazards models, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curves were used to evaluate the association between SII and AF recurrence. The predictive performance of SII was compared with that of C-reactive protein (CRP) and high-sensitivity C-reactive protein (hsCRP). Sensitivity analyses were performed to assess the robustness of findings. RESULTS: /L, above which the risk of recurrence increased markedly. ROC analysis demonstrated that SII had superior predictive performance compared to CRP and hsCRP (AUC 0.688 vs 0.510 and 0.542). Sensitivity analyses confirmed the robustness of SII across subgroups. CONCLUSION: SII is a valuable marker for predicting AF recurrence postablation in hypertensive patients. It supports inflammation-based risk assessments and should be considered in clinical risk stratification. Further research is needed to explore inflammation-targeted therapies.