Immunological coagulation dual axis stratification identifies ultra high-risk phenotypes in systemic sclerosis
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By
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Yaqi Zhao
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Yan An
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Qingrui Yang
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Zhenzhen Ma
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July 2, 2026
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Clinical Scorecard: Dual Axis Stratification of Immunological Coagulation Reveals Ultra High-Risk Phenotypes in Systemic Sclerosis
At a Glance
| Category | Detail |
|---|
| Condition | Systemic Sclerosis |
| Key Mechanisms | Immune activation, inflammation, coagulation, and fibrinolysis interplay |
| Target Population | Patients with systemic sclerosis, including those with interstitial lung disease and pulmonary hypertension |
| Care Setting | Hospitalized patients |
Key Highlights
- Patients with concurrent elevation of SII and DPR have a 7.41-fold higher mortality risk.
- Multi-index prognostic score achieved an AUC of 0.747 for mortality prediction.
- Three IICF molecular endotypes identified with incomplete concordance to ILD or PH.
Guideline-Based Recommendations
Diagnosis
- Diagnosis of systemic sclerosis confirmed by at least two rheumatology specialists.
- Pulmonary hypertension diagnosed via echocardiography with a threshold of systolic pulmonary arterial pressure ≥36 mmHg.
Management
- Utilization of IICF-based dual-axis stratification for precision phenotyping.
Monitoring & Follow-up
- Regular assessment of immune and coagulation markers to evaluate risk.
Risks
- Higher mortality risk associated with dual elevation of SII and DPR.
Patient & Prescribing Data
287 patients diagnosed with systemic sclerosis.
Synergistic interplay between immune activation and coagulation dysregulation as a pivotal mechanism.
Clinical Best Practices
- Employ multi-index scoring for better mortality risk prediction.
- Integrate immune and coagulation assessments in clinical evaluations.
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