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. 2025 Jun 16;14(12):4283.
doi: 10.3390/jcm14124283.

Inflammatory Indices in Patients with Myocardial Infarction Complicated by Cardiogenic Shock, and Their Interconnections with SCAI Stages and Patients' Survival: A Retrospective Study

Irina Kologrivova  1 , Maria Kercheva  1   2 , Oleg Panteleev  1   2 , Alexey Dmitriukov  1 , Ivan Zenkov  2 , Tatiana Suslova  1 , Vyacheslav Ryabov  1   2
Affiliations

Inflammatory Indices in Patients with Myocardial Infarction Complicated by Cardiogenic Shock, and Their Interconnections with SCAI Stages and Patients' Survival: A Retrospective Study

Irina Kologrivova et al. J Clin Med. .

Abstract

Background: Myocardial infarction complicated by cardiogenic shock (MI-CS) remains a critical condition with high mortality rates, despite advances in treatment. Systemic inflammation plays a significant role in MI-CS progression; however, its dynamics across different stages of the Society for Cardiovascular Angiography and Interventions (SCAI) classification remain poorly understood. This study aimed to evaluate indices of systemic inflammation-neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)-in MI-CS patients, correlating them with SCAI stages and survival outcomes. Methods: A single-center retrospective study included 132 patients with MI-CS, categorized into SCAI stages A-E. All patients were assessed for demographic, clinical, and laboratory data, procedural and treatment characteristics, MI timing, and outcomes. Complete blood count test data were used to calculate inflammatory indices and evaluate types of immune reactions. Results: PLR, SII, and AISI peaked at SCAI stage C and declined significantly at stage E, suggesting suppressed inflammation in advanced shock. SIRI emerged as a key prognostic marker for stage C patients, with elevated levels associated with larger infarct size, higher heart rate, and predominant innate immune activation. Patients with SIRI ≥ 3.34 had significantly lower two-year survival (log-rank test, p = 0.006). Conclusions: Inflammation indices, particularly SIRI, provide valuable prognostic insights in MI-CS, reflecting disease severity and heterogeneity of immune response. The decline in inflammatory indices at SCAI stage E may indicate immune suppression in extreme MI-CS, underscoring the need for personalized therapeutic strategies.

Keywords: AISI; SIRI; cardiogenic shock; inflammation; myocardial infarction; platelet-to-lymphocyte ratio; prognosis; survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Types of immune reactions in patients with myocardial infarction complicated by cardiogenic shock.
Figure 2
Figure 2
Systemic inflammation indices depending on the stages of myocardial infarction complicated by cardiogenic shock; simple ratios are marked with red color; complex indices are marked with blue color.
Figure 3
Figure 3
Kaplan–Meier curves for survival of myocardial infarction complicated by cardiogenic shock patients, SCAI stage C, with various levels of SIRI.
Figure 4
Figure 4
ROC curve of multiple logistic regression for classification of patients into groups with SIRI < 3.34 and SIRI ≥ 3.34. Upper line is based on the values of the model probability. Lower line represents reference line.
See this image and copyright information in PMC

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