Mode
Text Size
Log in / Sign up

Systemic inflammation indices MLR, SIRI, and AISI associated with carotid plaques in ACS patientsCould simple blood tests help spot hidden stroke risk after a heart attack?

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider MLR, SIRI, and AISI as potential inflammatory markers for carotid plaque risk in ACS patients, particularly women and non-diabetics.

A retrospective cohort study analyzed 7178 patients with acute coronary syndrome (ACS) to examine associations between systemic inflammation indices (NLR, MLR, NMLR, SIRI, SII, AISI, PLR) derived from routine blood tests and carotid plaque presence. Patients with carotid plaques had significantly higher values across all seven indices compared to those without plaques. After full multivariable adjustment, MLR, SIRI, and AISI showed significant non-linear associations with carotid plaques, with inflection points at 0.26, 0.9, and 205, respectively.

In quartile comparisons, the highest quartile was associated with increased odds of carotid plaques for MLR (OR 1.453), SIRI (OR 1.409), and AISI (OR 1.379) compared to the lowest quartile. Subgroup analyses revealed these associations were mainly observed in women and non-diabetic patients. In patients with hypertension, MLR, SIRI, and AISI remained positively associated with carotid plaques.

Safety and tolerability data were not reported in this observational analysis. Key limitations include the retrospective design, lack of reported effect sizes, p-values, or confidence intervals for most findings, and absence of follow-up duration. The study did not report funding sources or conflicts of interest.

For clinical practice, MLR, SIRI, and AISI may serve as potential markers for ischemic stroke risk stratification in ACS patients, particularly in specific subgroups. However, these findings represent associations rather than causal relationships and require validation in prospective studies before clinical implementation.

When someone has a heart attack, doctors immediately work to prevent the next crisis, often a stroke. A key warning sign is plaque buildup in the carotid arteries in the neck, which can break off and cause a stroke. This study looked for a simpler way to spot that risk.

Researchers analyzed data from over 7,000 patients who had an acute coronary syndrome (a heart attack or unstable angina). They calculated several inflammation scores from standard blood cell counts. They found that patients who had carotid plaques had higher scores across the board. Three scores in particular—MLR, SIRI, and AISI—showed a strong, independent link to having these dangerous plaques. The link was especially clear in women and in patients without diabetes.

This was a retrospective study, meaning it looked back at existing records. While it shows a connection, it can't prove that higher inflammation causes the plaque to form. The findings point to these simple blood markers as potential tools for flagging patients who might need closer monitoring for stroke risk after a heart event. More research is needed to see if tracking these scores can actually help prevent strokes.

What this means for you:
Simple blood markers may signal hidden stroke risk after a heart attack, especially for women.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundIschemic stroke is a leading cause of death and disability worldwide. Identifying patients with carotid atherosclerosis who are at high risk is clinically important. Acute coronary syndrome (ACS) is a manifestation of systemic atherosclerosis, in which inflammation plays a key role in plaque progression and destabilization. However, the relationship between blood cell-derived systemic inflammation indices and carotid plaque burden in patients with ACS remains unclear.MethodsThis retrospective study included 7,178 patients with ACS. Carotid ultrasound was used to classify patients into carotid plaque and non-plaque groups. Systemic inflammation indices—including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), systemic immune-inflammatory index (SII), aggregate index of systemic inflammation (AISI), and platelet-to-lymphocyte ratio (PLR)—were calculated from routine blood tests. Multivariable logistic regression, restricted cubic spline models, and subgroup analyses were used to evaluate their associations with carotid plaques.ResultsPatients with carotid plaques had significantly higher NLR, MLR, NMLR, SIRI, SII, AISI, and PLR. After full adjustment, MLR, SIRI, and AISI showed significant non-linear associations with carotid plaques, with inflection points of 0.26, 0.9, and 205, respectively. Compared with the lowest quartile, the highest quartile was associated with increased odds of carotid plaques for MLR (OR 1.453), SIRI (OR 1.409), and AISI (OR 1.379). Subgroup analyses showed that these associations were mainly observed in women and in non-diabetic patients. In patients with hypertension, MLR, SIRI, and AISI remained positively associated with carotid plaques.ConclusionMLR, SIRI, and AISI are independently associated with carotid plaques in patients with ACS, particularly among women and non-diabetic individuals, and may serve as potential markers for ischemic stroke risk stratification in this population.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.