The Predictive Role of Systemic Immune Inflammation Index to the Aortic Valve Calcification in the Elderly Population with Chronic Renal Failure

Yurdam F. S., Kış M.

E Journal of Cardiovascular Medicine, vol.11, no.1, pp.11-16, 2023 (Peer-Reviewed Journal)



Aortic valve calcification (AVC) is a chronic, degenerative and progressive condition that results of endothelial injury, cholesterol deposition, myofibroblast differentiation and subsequent valve calcification, involving complex pathophysiological mechanisms such as the activation of inflammatory and immune system cells. The frequency of AVC increased in the presence of chronic renal failure (CRF) and with age. The study aimed to reveal the relationship between AVC and systemic immune inflammation index (SII) that includes peripheral neutrophil, lymphocyte and platelet counts in the elderly population with chronic renal failure.

Materials and Methods:

Patients over 65 years of age who applied to the cardiology outpatient clinic with chronic renal failure between March 2018 and October 2022 were included in the study. The patients were divided into two groups as group 1 (control group- undetected AVC on echocardiography) (70 patients) and group 2 (AVC detected on echocardiography) (70 patients). SII of all patients was defined as: SII = neutrophil count × platelet count/lymphocyte count. Our study was a retrospective, observational study.


The mean SII value was statistically significantly higher in group 2 (754.2±268.7) than group 1 (622.79±297.2, p=0.007). In the univariable regression analysis of the factors affecting AVC in elderly patients with CRF, neutrophil [odds ratio (OR): 0.752; 95% confidence interval (CI): 0.605-0.934, p=0.01], lymphocytes (OR: 2,197; 95% CI: 1,346-3,585, p=0.002), and SII (OR: 0.998; 95% CI: 0.997-1.000, p=0.009) were predictors. In the multivariable regression analysis: SII (OR: 1.002; 95% CI: 1.000-1.005, p=0.034), lymphocytes (OR: 5,660; 95% CI: 2,349-13,637, p<0.001) and neutrophil (OR: 497; 95% CI: 0.344-0.717, p<0.001) were found to be independent predictors. SII> 633.4, 64% sensitivity, and 65% specificity (receiver operating characteristic area under curve: 0.672, 95% CI: 0.582-0.762, p<0.001) are associated with aortic valve sclerosis.


High SII in the elderly with chronic renal failure is associated with the presence of AVCs.

Keywords: Aort calcification, systemic immune inflammation index, and predictivity