Clinical Scorecard: Evaluating the Prognostic Significance of the Systemic Inflammatory Response Index (SIRI) in Patients with Acute Coronary Syndrome Undergoing Primary Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

At a Glance

Key Highlights

• SIRI is a novel composite inflammatory biomarker calculated as neutrophil count × monocyte count / lymphocyte count
• Elevated SIRI levels are associated with increased all-cause mortality and major adverse cardiovascular events (MACE) post-PCI
• Inflammation plays a critical role in infarct expansion, plaque instability, and recurrent ischemic risk in ACS

Guideline-Based Recommendations

Diagnosis

• Consider measuring SIRI as part of risk stratification in ACS patients undergoing PCI

Management

• Use SIRI levels to identify high-risk patients for tailored post-PCI therapeutic strategies
• Incorporate inflammation control as a secondary prevention target in CAD management

Monitoring & Follow-up

• Monitor SIRI to assess residual inflammatory risk and guide long-term management post-PCI

Risks

• High SIRI indicates increased pro-inflammatory activity linked to worse prognosis and higher risk of recurrent cardiovascular events

Patient & Prescribing Data

Patients with acute coronary syndrome treated with primary PCI

SIRI can help identify patients at higher risk of mortality and MACE, supporting individualized treatment and optimized post-discharge care

Clinical Best Practices

• Integrate SIRI measurement into routine evaluation of ACS patients undergoing PCI for improved prognostic accuracy
• Combine SIRI assessment with clinical and procedural factors to enhance risk stratification
• Address residual inflammatory risk through targeted anti-inflammatory therapies alongside standard CAD treatments

References

• PRISMA 2020 Statement
• PROSPERO Registration CRD420251084474