{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:01:51Z","timestamp":1789052511932,"version":"build-2803163510"},"reference-count":106,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Coronary heart disease (CHD) is essentially a thrombo-inflammatory disease, and its key pathological mechanism lies in an acute thrombotic storm driven by the interaction between platelets, neutrophils, and lymphocytes. Existing inflammatory markers, which reflect only a single dimension, struggle to accurately capture this complex network. The Systemic Immune-Inflammation Index (SII), calculated using the formula (platelets\u2009\u00d7\u2009neutrophils\/Lymphocytes), integrates the three dimensions of thrombosis, inflammation, and immunity, providing a novel composite indicator for quantifying the thrombo-inflammatory burden. This article provides a review of the latest evidence regarding SII in the risk stratification of coronary heart disease. Existing studies indicate that the predictive utility of SII exhibits significant phenotype dependence: it peaks in acute coronary syndrome (ACS) and related complications, accurately reflecting the intensity of acute thromboinflammatory storms; whereas in chronic coronary syndrome (CCS), its utility is diminished, serving merely as a tool for monitoring background inflammation. This dual characteristic of \u201cacute warning and chronic monitoring\u201d stems from its pathological specificity-the SII molecule (P\u2009\u00d7\u2009N) directly reflects the synergistic amplification effect of platelet-neutrophil interactions and performs best in thrombus-driven events. Clinical evidence supports the establishment of a three-tiered threshold system: (1) Acute-phase high-risk threshold (&amp;gt;900\u20131400), used for predicting ACS major adverse cardiovascular events (MACE) and stratifying mortality risk; (2) Complication stratification thresholds (screening: 450\u2013650; diagnosis: &amp;gt;1,000), to guide the identification and intervention of microvascular complications such as no-reperfusion phenomenon (NRP); (3) Chronic-phase monitoring thresholds (&amp;gt;650), indicating anatomical complexity rather than an independent prognostic factor. However, the clinical translation of SII remains limited: cut-off values show high heterogeneity (459\u20132,174), comparisons with the Systemic Inflammatory Response Index (SIRI) and the Pan-Inflammatory Value (PIV) remain controversial, and most existing evidence comes from observational studies. Future efforts should focus on establishing the mechanism-specificity of SII by validating its association with direct thrombotic and inflammatory markers such as neutrophil extracellular traps (NETs), developing phenotype-adaptive risk models, and conducting randomized controlled trials to verify whether SII-guided intensified anticoagulation or anti-inflammatory interventions (such as colchicine) can improve clinical outcomes. The transition from a risk stratification tool to an indicator for precision treatment decision-making represents the next critical step in the clinical application of SII.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1778315","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:43:11Z","timestamp":1777351391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The systemic immune-inflammation index in coronary heart disease: a narrative review of thromboinflammation, phenotype-dependent utility, and clinical translation"],"prefix":"10.3389","volume":"13","author":[{"given":"Mengyao","family":"Liu","sequence":"first","affiliation":[{"name":"Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaojiao","family":"Mao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaili","family":"Wang","sequence":"additional","affiliation":[{"name":"Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henghe","family":"Wang","sequence":"additional","affiliation":[{"name":"Cardiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4019","DOI":"10.1093\/eurheartj\/ehae466","article-title":"European society of cardiology: the 2023 atlas of cardiovascular disease statistics","volume":"45","author":"Timmis","year":"2024","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1161\/CIR.0000000000001303","article-title":"2025 Heart disease and stroke statistics: a report of US and global data from the American Heart 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