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. 2025 Apr 29:15:1552341.
doi: 10.3389/fonc.2025.1552341. eCollection 2025.

Association of aggregate index of systemic inflammation with increased all-cause and cardiovascular mortality in female cancer patients

Ying Yang  1   2 , Zelin Hu  3 , Yuqin Ye  4 , Haoqi Wu  3 , Wei Sun  2 , Ning Wang  3
Affiliations

Association of aggregate index of systemic inflammation with increased all-cause and cardiovascular mortality in female cancer patients

Ying Yang et al. Front Oncol. .

Abstract

Background: Cancer is a leading cause of death, especially among women, with cancers like breast, ovarian, and cervical cancer presenting unique diagnostic and treatment challenges. Systemic inflammation plays a significant role in cancer progression, affecting both tumor development and therapeutic outcomes. Despite the established link between inflammation and cancer, comprehensive studies on the prognostic value of the Aggregate Index of Systemic Inflammation (AISI) in female cancer patients are lacking. This study explores the association between AISI and mortality outcomes, including all-cause and cardiovascular mortality, in female cancer patients.

Methods: This study analyzes data from the NHANES database and Dandong Central Hospital. Kaplan-Meier survival curves and multivariable Cox proportional hazards regression analyses were used to assess the relationship between AISI and all-cause and cardiovascular mortality. Restricted cubic spline plots and subgroup analyses were applied to explore potential interactions.

Results: Elevated AISI levels were strongly associated with increased all-cause and cardiovascular mortality. Patients in the highest AISI quartile demonstrated significantly higher mortality risks compared to those in the lowest quartile. ROC curve analysis indicated superior predictive performance of AISI over SII. Restricted cubic spline plots revealed a linear relationship, with mortality risk notably increasing when AISI levels were elevated.

Conclusion: AISI is a robust predictor of all-cause and cardiovascular mortality in female cancer patients. Its ease of measurement and strong prognostic value make it a valuable tool for risk assessment and management in this population.

Keywords: AISI; NHANES; aggregate index of systemic inflammation; female cancer; mortality.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Selection process for study cohorts.
Figure 2
Figure 2
Kaplan-Meier survival curves for all-cause mortality (A) and cardiovascular mortality (B) stratified by AISI quartiles, adjusted for age, race, education, poverty-to-income ratio, hypertension, diabetes, BMI, alcohol use, and smoking.
Figure 3
Figure 3
ROC curves were utilized to assess the differences in predictive abilities of SII and AISI for all-cause (A) and cardiovascular (B) mortality in female cancer patients. ROC receiver operating characteristic curve, AUC area under the curve.
Figure 4
Figure 4
Association between AISI and all-cause mortality (A) and cardiovascular mortality (B) in participants with female cancer, adjusted for age, race, education, poverty-to-income ratio, hypertension, diabetes, BMI, alcohol use, and smoking. The shaded areas represent the 95% CI.
Figure 5
Figure 5
Subgroup analysis of the associations between AISI and all-cause and cardiovascular mortality, adjusted for age, race, education, poverty-to-income ratio, hypertension, diabetes, BMI, alcohol use, and smoking.
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