Objective:

To evaluate whether SII independently predicts major adverse cardiovascular events (MACE) in patients with angiographically confirmed coronary artery ectasia (CAE).

Approach:

• Study Design: Retrospective cohort study at Cangzhou Central Hospital involving 200 consecutive patients with CAE followed for a median of 30 months.
• SII Calculation: SII was calculated as platelet count × neutrophil count / lymphocyte count.
• Endpoints: Primary endpoint was MACE, defined as cardiovascular death, nonfatal myocardial infarction, ischemic stroke, and target vessel revascularization.
• Statistical Analysis: ROC curve analysis for optimal SII cut-off value; Kaplan–Meier survival analysis and Cox proportional hazards regression for outcome association.

Key Findings:

• During follow-up, 18% of patients experienced MACE.
• Baseline SII levels were significantly higher in patients who developed MACE.
• ROC analysis demonstrated good discriminatory ability of SII for predicting MACE (AUC 0.81), with an optimal cut-off value of 645.
• Kaplan–Meier analysis showed significantly lower event-free survival in patients with high SII levels.
• In multivariate Cox regression analysis, SII remained independently associated with MACE.

Interpretation:

Elevated SII is an independent predictor of MACE in CAE patients, enhancing prognostic accuracy when incorporated into clinical risk assessment models.

Limitations:

• Retrospective design may introduce selection bias.
• Single-center study limits generalizability.

Conclusion:

SII may serve as a valuable tool for risk stratification in patients with coronary artery ectasia.