Introduction.

Inflammation, insulin resistance, and dyslipidemia are key pathophysiological mechanisms involved in atherosclerotic cardiovascular disease which may be quantified by the systemic immune-inflammation index (SII), the triglyceride-glucose index (TyG), and the lipid accumulation product (LAP), respectively.

Objective.

To compare the predictive capacity of the SII, TyG and LAP for coronary artery disease (CAD) severity.

Methodology.

A cross-sectional study was conducted on 73 patients with chronic CAD; cardiovascular risk factors, statin use and laboratory values were used. CAD severity was determined through assessment of angiographic features for the application of the SYNTAX score. The SII was calculated as absolute platelet count × (absolute neutrophil count / absolute lymphocyte count); while the TyG index was calculated using the formula: ln [triglycerides × fasting glucose] / 2, on a logarithmic scale; and LAP was calculated as waist circumference (cm) - 65 × triglycerides (mmol/L) for men; and waist circumference - 58 × triglycerides for women.

Results.

The average age was 59.5±7.7 years, with a predominance of men in the sample (50.7%; n = 37). Of the indices evaluated, SII showed the greatest area under the curve (AUC) for the prediction of moderate to severe CAD (AUC: 0.73 CI95%: 0.61-0.85), a cut-off point off 378.4 with a sensitivity of 71.4% and specificity of 66.6%. In the multivariate analysis, subjects with an SII value ≥378.4 displayed an increased risk for higher CAD severity (OR: 7.56; CI95%: 1.62-35.28; P = 0.01).

Conclusions.

SII had a greater predictive capacity for moderate to severe CAD in comparison to TyG and LAP, demonstrating the importance of inflammation in chronic atherosclerotic disease.

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