{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:41:10Z","timestamp":1792219270731,"version":"4.4.0"},"reference-count":73,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Inflammation plays a key role in acute coronary syndromes (ACS). The systemic immune-inflammation index (SII), which integrates immune and inflammatory markers, may serve as a valuable prognostic tool. This study aimed to evaluate the utility of SII as a short-term predictor of mortality and major adverse cardiovascular and cerebral events (MACCE) in ACS patients. Methods: A retrospective analysis was conducted on 964 ACS patients admitted in 2023. SII was calculated from admission hematological parameters. Primary and secondary outcomes were 30-day mortality and MACCE, respectively. Results: SII levels differed significantly across ACS subtypes (p &lt; 0.001), highest in ST-segment elevation myocardial infarction (STEMI) and lowest in unstable angina. SII was markedly higher in deceased patients (2003.79 \u00b1 1601.17) vs. survivors (722.04 \u00b1 837.25; p &lt; 0.001) and remained an independent predictor of mortality (OR = 1.038, p &lt; 0.001). Similarly, SII was elevated in MACCE cases (1717 \u00b1 1611.32) vs. non-MACCE (664.68 \u00b1 713.11; p &lt; 0.001) and remained predictive in multivariate analysis (OR = 1.080, p &lt; 0.001). Predictive accuracy for MACCE was moderate (AUC = 0.762), improved when combined with GRACE 2, especially in specificity (p = 0.07). In STEMI, SII had excellent accuracy (AUC = 0.874), outperforming neutrophil\u2013lymphocyte ratio and C-reactive protein. SII rose at 24 h and declined at 48 h in STEMI, with a slower decline in MACCE patients. Conclusions: SII proved to be a cost-effective biomarker reflecting inflammation, immunity, and thrombosis. Elevated SII predicted short-term MACCE and mortality in ACS, with improved prognostic power when combined with GRACE 2. Persistent elevation may signal ongoing inflammation and increased MACCE risk.<\/jats:p>","DOI":"10.3390\/medsci13030116","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T09:56:42Z","timestamp":1754647002000},"page":"116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Risk Stratification in Acute Coronary Syndromes: The Systemic Immune-Inflammation Index as Prognostic Marker"],"prefix":"10.3390","volume":"13","author":[{"given":"Elena Emilia","family":"Babes","sequence":"first","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-8177","authenticated-orcid":false,"given":"Andrei-Flavius","family":"Radu","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi Adaus","family":"Cretu","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Bungau","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6837-260X","authenticated-orcid":false,"given":"Camelia Cristina","family":"Diaconu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania"},{"name":"Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, 050085 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0296-6592","authenticated-orcid":false,"given":"Delia Mirela","family":"Tit","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Vlad","family":"Babes","sequence":"additional","affiliation":[{"name":"Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e13230","DOI":"10.1111\/eci.13230","article-title":"Systemic Immune-Inflammation Index (SII) Predicted Clinical Outcome in Patients with Coronary Artery Disease","volume":"50","author":"Yang","year":"2020","journal-title":"Eur. 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