ESC Congress 2026 Abstract · Oct 26, 2026
Relationship between cumulative exposure to systemic inflammation response index and risk of all-cause mortality in middle-aged and older adults with cardiovascular-kidney-metabolic syndrome stage 0–2
By Liu X, Chen W, Chen Y et al.
Background: The systemic inflammation response index (SIRI) was associated with higher risk of mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–2. However, the long-term effect of high SIRI on all-cause mortality risk remains unclear in middle-aged and elderly individuals with CKM syndrome stages 0–2. Objective: This study aimed to evaluate the relationship between the cumulative SIRI and the risk of all-cause mortality in middle-aged and elderly individuals with CKM syndrome stages 0–2. Methods: Participants were enrolled from the Tongzhou cohort, who participated in health examinations in 2016 and 2018. The cumulative SIRI was calculated as the weighted sum (value × time) of the mean SIRI for each time interval, reflecting the cumulative inflammatory burden over time. The participants were categorized into high and low cumulative SIRI groups based on the cut-off value determined by time-dependent receiver operating characteristic (ROC) curve analysis. Follow-up ended on December 31, 2024, and the primary outcome was all-cause mortality. In addition, a Cox proportional hazards regression model and a restricted cubic spline (RCS) analysis were performed to further evaluate the relationship between cumulative SIRI and all-cause mortality risk. Results: A total of 3,410 middle-aged and elderly participants with CKM syndrome stages 0–2 were enrolled. During a median follow-up of 5.73 years, 71 all-cause deaths (2.08%) occurred. After adjusting for potential confounders, high cumulative SIRI was associated with an increased risk of all-cause mortality (HR = 2.29, 95% CI: 1.03–5.07). Subgroup analysis revealed no significant interactions between cumulative SIRI and age, sex, marital status, education, smoking, or drinking status. RCS analysis showed a linear positive association between cumulative SIRI and all-cause mortality risk. Conclusions: High cumulative SIRI was independently associated with an increased risk of all-cause mortality among middle-aged and older individuals with CKM syndrome stages 0–2. Thus, long-term dynamic monitoring of cumulative SIRI may be useful for the early identification and assessment of individuals at high risk of mortality.