The Prognostic Value of Systemic Inflammation Immune Index in Acute Myocardial Infarction Patients Treated by Renin Angiotensin System Blockers

Background: One mechanism that regulates several cellular activities is the renin-angiotensin-aldosterone system (RAAS). The vast array of peptides that make up this system encompass chemicals that regulate inflammatory processes, cellular progression, electrolyte and water balance, vascular integrity and signaling activation across several organs in both physiological and pathological states.
Objectives: This study aimed to assess the value of using RAS blockers on lowering the inflammatory indices in acute myocardial infarction (AMI) patients and to assess the impact of low inflammatory indices on short-term outcome after myocardial infarction
Subjects and methods: This prospective cohort research included 125 AMI patients and was conducted in Cardiology Department, Zagazig University Hospital.
Result: Functional capacity, EF, and creatinine levels were statistically significant independent predictors (p<0.05). Among them, functional capacity had the strongest standardized effect (β = 0.45, p = 0.002), followed by EF (β = 0.30, p = 0.015) and creatinine (β = 0.25, p = 0.037).  However, symptoms did not reach statistical significance (p = 0.32), indicating that it was not an independent determinant in this model. The levels of BNP continued to have a role in systemic immune-inflammation (SII) as independent variables. The sole independent determining factor influencing SIRI was creatinine levels.
Conclusion: This study demonstrated that cases with AMI who were previously managed by Renin-Angiotensin System Blockers (RASB) had significantly lower systemic immune-inflammation index (SII) values, suggesting a potential anti-inflammatory benefit of this therapy. Furthermore, lower inflammatory indices were linked to better functional capacity, preserved ejection fraction and improved renal function, which collectively contribute to favorable short-term outcomes. While SII and systemic inflammatory response index (SIRI) appear to be promising markers for risk stratification in AMI, their predictive value is influenced by cardiac and renal parameters. Incorporating inflammatory indices alongside conventional clinical and biochemical predictors may enhance early prognostic assessment in myocardial infarction.