Pan-Immune-Inflammation Value Is Independently Correlated to Impaired Coronary Flow After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction

Immune-inflammatory biomarkers have been shown to be correlated with impaired coronary flow (ICF) in ST-segment elevation myocardial infarction (STEMI). Herein, we assessed the relationship between a novel comprehensive biomarker, pan-immune-inflammation value (PIV), and ICF after primary percutaneous coronary intervention (pPCI) in STEMI. A total of 687 patients underwent pPCI between 2019 and 2023 were retrospectively analyzed. Blood samples were collected at admission. PIV and other inflammation parameters were compared. PIV was calculated as (neutrophil count × platelet count × monocyte count)/lymphocyte count. Post-procedural coronary flow was assessed by thrombolysis in myocardial infarction (TIMI) classification. Patients were divided into two groups: a group with ICF defined as post-procedural TIMI 0-2 and a group with normal coronary flow (NCF) defined as post-procedural TIMI flow grade of 3. The mean age was 61±12 years and 22.4% were women. Compared to the NCF group (median 492, interquartile range [IQR] 275-931), the ICF group (median 1540, IQR 834-2909) showed significantly increased PIV (p<0.001). The optimal cutoff for the PIV was 804, as determined by receiver operating characteristic curve. The incidence of ICF was 17.0% in whole subjects, 6.4% in low PIV group (<804) and 34.2% in high PIV group (≥804). Multivariate analyses revealed that a baseline PIV ≥804 was independently associated with post-pPCI ICF (Odds ratio 5.226, p<0.001). PIV was superior to neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in determining of ICF. In conclusion, a high PIV was significantly associated with an increased risk of ICF after pPCI. Moreover, PIV was a better indicator of ICF than other inflammatory markers.