Search Results (39)

Climate change research is increasingly important in regions vulnerable to extreme hydrometeorological events like droughts, which pose significant socio-economic and environmental challenges. This study examines future variability of meteorological drought in northernmost South America using the Standardized Precipitation Index (SPI) and precipitation projections from CMIP6 models. We first evaluated model performance by comparing historical simulations with observational data from the Climate Hazards Group InfraRed Precipitation with Station dataset for 1981–2014. Among the models, CNRM-CM6-1-HR was selected for its superior accuracy, demonstrated by the lowest errors and highest correlation with observed data—specifically, a correlation coefficient of 0.60, a normalized root mean square error of 1.08, and a mean absolute error of 61.37 mm/month. Under SSP1-2.6 and SSP5-8.5 scenarios, projections show decreased rainfall during the wet months in the western Perijá mountains, with reductions of 3% to 26% between 2025 and 2100. Conversely, the Sierra Nevada of Santa Marta is expected to see increases of up to 33% under SSP1-2.6. During dry months, northern Colombia and Venezuela—particularly coastal lowlands—are projected to experience rainfall decreases of 10% to 17% under SSP1-2.6 and 13% to 20% under SSP5-8.5. These areas are likely to face severe drought conditions in the mid and late 21st century. These findings are essential for guiding water resource management, enabling adaptive strategies, and informing policies to mitigate drought impacts in the region. Full article

Background: The diagnostic accuracy of the exercise treadmill test (ETT) remains suboptimal in premenopausal women. Menstrual cycle phases display hormonal variations and biological effects in premenopausal women. The early and late follicular phases of the menstrual cycle demonstrate nearly four-fold differences in estrogen levels. Methods: This study assessed the variability in ETT results between the early and late follicular phases in premenopausal women. This study included premenopausal females with regular menstrual cycles and chest pain. As per the study protocol, patients underwent two separate ETTs at the early and late follicular phases of the menstrual cycle. Hormones and high-sensitivity cardiac troponin T (hs-cTnT) were measured. The primary endpoint was the ST segment/heart rate (HR) index. The secondary endpoints were maximum ST/HR slope, ST segment depression, HR and blood pressure (BP) response, exercise capacity, and hs-cTnT change after ETT. Results: False-positive ETT results were common in premenopausal women. The early follicular phase displayed significantly higher hs-cTnT and BP responses to ETT compared to the late follicular phase. This study reports that ETT results are similar between the early and late follicular phases of the menstrual cycle in premenopausal women. Biological variability is observed in the BP and hs-cTnT response to ETT between the two phases. Conclusions: The menstrual cycle phase (early versus late follicular phase) did not affect the ETT results. The consideration of estrogen and hormonal status when evaluating the diagnostic test results can improve our understanding of cardiovascular disease in women. Full article

Background/Objectives: Obesity is increasingly common among patients with acute ST-segment elevation myocardial infarction (STEMI), potentially influencing both clinical evaluation and outcomes. Traditional echocardiographic metrics may be suboptimal for prognosis estimation in this population. Left ventricular myocardial work (LVMW) represents an emerging, load-adjusted marker of myocardial performance. This study aimed to assess the prognostic relevance of LVMW in obese STEMI patients. Methods: A total of 143 patients presenting with STEMI were prospectively enrolled and categorized based on their obesity status (body mass index ≥30 kg/m²). LVMW parameters were measured using echocardiography within 72 ± 24 h of hospital admission. The patients were monitored for major adverse cardiovascular events (MACE), defined as cardiovascular death, malignant ventricular arrhythmias, or unplanned hospitalizations due to heart failure or acute coronary syndrome. Results: During a median follow-up of 13 months (interquartile range: 6–28 months), MACE occurred in 30 patients (21%). Among obese individuals, left ventricular global work efficiency (LVGWE) emerged as the most robust predictor of adverse events, with an area under the receiver operating characteristic curve of 0.736 (95% confidence interval [CI]: 0.559–0.914; p = 0.009). A threshold value of 79% for LVGWE was identified as optimal for predicting MACE. Kaplan–Meier analysis revealed significantly lower event rates in obese patients with LVGWE ≥79% (log-rank p = 0.006). In univariate Cox regression analysis, LVGWE <79% was associated with a markedly elevated risk of MACE in obese patients (hazard ratio [HR] = 5.59; 95% CI: 1.33–23.50; p = 0.019), and remained a significant predictor in the overall cohort (HR = 2.73; 95% CI: 1.26–5.90; p = 0.010). Conclusions: LVGWE demonstrates strong prognostic utility in STEMI, particularly among obese patients. The incorporation of myocardial work indices into routine evaluation may enhance risk stratification and guide management in this high-risk subgroup. Full article

Background and Objectives: The prognostic value of Left Ventricular Global Function Index (LVGFI) in chronic cardiovascular diseases is well-documented; however, limited evidence exists for its utility in non-ST elevation myocardial infarction (NSTEMI). This study aims to evaluate LVGFI as a predictor of three-year mortality and major adverse cardiovascular events (MACE) in NSTEMI patients. Materials and Methods: This retrospective cohort study included 432 NSTEMI patients divided into tertiles based on LVGFI values: T1 (low), T2 (intermediate), and T3 (high). LVGFI values were derived from echocardiographic imaging. Kaplan–Meier survival analysis was used to assess outcomes, and the Cox proportional hazards models, adjusted for demographics and clinical covariates, determined the association between LVGFI tertiles and three-year outcomes. Results: The average age and sex distribution were similar across tertiles with no significant differences in cardiovascular risk factors or most laboratory parameters. However, significant differences were noted in body surface area (higher in T3), platelet counts (higher in T1), and triglyceride levels (lower in T3). The ROC analysis identified an optimal LVGFI cut-off of 23.22 for predicting three-year mortality, with a sensitivity of 72% and specificity of 75% (AUC: 0.81; 95% CI: 0.74–0.87, p < 0.001). Patients in the T1 exhibited a three-year mortality rate of 25%, compared to 2.1% in the T3. After adjustment, the hazard ratio (HR) for mortality was significantly higher in T1 (HR 11.86; 95% CI: 3.60–39.10) compared to T3. Similarly, MACE rates were highest in T1 (27.1%) and lowest in T3 (7.6%). Conclusions: LVGFI is a significant independent predictor of three-year mortality and MACE in NSTEMI patients. Full article

Background: Lower socioeconomic status (SES) has been associated with increased mortality from coronary heart disease. This excess risk, relative to affluent patients, may be due to a combination of more adverse cardiovascular-risk factors, inequalities in access to cardiac investigations, longer waiting times for cardiac revascularisation and lower use of secondary prevention drugs. We sought to investigate whether socio-economic status influenced long-term all-cause mortality after PCI in a large metropolitan city (London), which serves a population of 11 million people with a mixed social background over a 10-year period. Methods: We conducted an observational cohort study of 123,780 consecutive PCI procedures from the Pan-London (United Kingdom) PCI registry. This data set is collected prospectively and includes all patients treated between January 2005 and December 2015. The database includes PCI performed for stable angina and ACS (ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina). Patient socio-economic status was defined by the English Index of Multiple Deprivation (IMD) score, according to residential postcode. Patients were analysed by quintile of IMD score (Q1, least deprived; Q5, most deprived). Median follow-up was 3.7 (IQR: 2.0–5.1) years and the primary outcome was all-cause mortality. Results: The mean age of the patients was 64.3 ± 12.1 years and 25.2% were female. A total of 22.4% of patients were diabetic and 27.3% had a history of previous myocardial infarction. The rates of long-term all-cause mortality increased progressively across quintiles of IMD score, with patients in Q5 showing significantly higher long-term mortality rates compared with patients in Q1 (p = 0.0044). This persisted following the inclusion of a propensity score in the proportional hazard model as a covariate (HR for Q5 compared to Q1: 1.15 [95% CI: 1.10–1.42]). Conclusions: This study has demonstrated that low SES is an independent predictor of adverse clinical outcomes following PCI in the large, diverse metropolitan city of London. There clearly are inequalities in cardio-vascular risk factors, time to access to medical treatment/PCI, access to complex imaging and devices during PCI, access to secondary prevention after PCI, and even race differences. Hence, attention to reducing the burden of cardiovascular risk factors and improving primary prevention, particularly in patients with lower SES, is required. Full article

Natriuretic peptides are established biomarkers related to the prognosis of heart failure. New biomarkers have emerged in the field of cardiovascular disease. The prognostic value of these biomarkers in heart failure with reduced left ventricular ejection fraction is not well-established. We conducted a prospective, single-centre study, including (July 2019 to March 2023) 104 patients being consecutively admitted with a diagnosis of acute heart failure with reduced ejection fraction decompensation. The median follow-up was 23.5 months, during which 20 deaths (19.4%) and 21 readmissions for heart failure (20.2%) were recorded. Plasma biomarkers, such as NT-proBNP, GDF-15, sST2, suPAR, and FGF-23, were associated with an increased risk of all-cause mortality. However, a Cox regression analysis showed that the strongest predictors of mortality were an estimated glomerular filtration rate (HR 0.96 [0.93–0.98]), GDF-15 (HR 1.3 [1.16–1.45]), and sST2 (HR 1.2 [1.11–1.35]). The strongest predictive model was formed by the combination of the glomerular filtration rate and sST2 (C-index 0.758). In conclusion, in patients with acute decompensated heart failure with reduced ejection fraction, GDF-15 and sST2 showed the highest predictive power for all-cause mortality, which was superior to other established biomarkers such as natriuretic peptides. GDF-15 and sST2 may provide additional prognostic information to improve the prognostic assessment. Full article

Background: This study aims to evaluate the repeatability of the Pentacam HR, comparing two different measurement modes (50-cornea fine and 25-3D scan) in patients affected by keratoconus. Methods: Multicenter retrospective study, conducted at Eye Clinic of the ASST-Spedali Civili-University of Brescia, Italy, and St. Paul’s Eye Unit, Royal Liverpool University Hospital, United Kingdom. A total of 72 eyes from 72 patients with keratoconus underwent six consecutive measurements, three using the 25-3D scan mode and three with the 50-Cornea fine mode. Measurements were made by one single observer, using the Scheimpflug corneal tomographer camera (Pentacam HR, Oculus, Wetzlar, Germany). Repeatability was assessed using the within-subject SD (S_w) statistic from a two-way analysis of variance. Results: Both measurement modes had excellent repeatability. The interclass coefficient correlation (ICC) was excellent (>0.9) in all the parameters evaluated, apart from anterior and posterior astigmatic axes and posterior astigmatism (ICC > 0.8) and index of height asymmetry (IHA) (ICC < 0.6). However, in 18 of 29 parameters, the ICC was higher in case of 25-3D scan. Repeatability limit for Kmax was 1.00D in 25-3D scan mode and 1.02D in case of 50-cornea fine. Conclusions: 25-3D scan may be preferable to 50-Cornea fine, in view of having slightly higher ICC in case of patients with keratoconus. Repeatability limits reported may be helpful in clinical practice for assessing the progression of keratoconus. Full article

Serum albumin and body mass index (BMI, kg/m²) have been associated with outcomes following acute myocardial infarction (AMI). Aiming to assess whether the mortality risk inflicted by hypoalbuminemia (<3.5 g/dL) in this context is influenced by BMI, we conducted a retrospective analysis of AMI survivors hospitalized during 2004–2017. Stratified by admission-time albumin level and BMI, eligible cases were evaluated for all-cause mortality up to 10 years after discharge. A total of 6283 individuals (74.1% males, mean age 64.1 ± 13.1 years, 44.3% with ST-elevation MI) were included. Of them, 22.7% had hypoalbuminemia and 1.2%, 41.0%, and 28.6% were underweight (BMI < 18.5), overweight (BMI 25–30), and obese (BMI ≥ 30), respectively. Over a median of 7.9 (IQR, 4.8–10.0) years of follow-up, 42.5% of patients died. Hypoalbuminemia was independently associated with a heightened mortality risk overall (AdjHR = 1.54, 95%CI 1.42–1.67, p < 0.001), accounted for by the normal weight (AdjHR = 1.73, 95%CI 1.50–1.99, p < 0.001), overweight (AdjHR = 1.55, 95%CI 1.35–1.79, p < 0.001), and class 1 obesity (BMI 30–35) (AdjHR = 1.37, 95%CI 1.12–1.68, p = 0.002) subgroups. Upon interaction analysis, the mortality risk imposed by hypoalbuminemia was most pronounced among individuals with normal BMI. In conclusion, hypoalbuminemia constituted a negative prognostic marker for long-term survival in AMI patients with normal or mildly elevated but not reduced or severely increased BMI. Pending further research, addressing hypoalbuminemia based on BMI range may prove beneficial. Full article

Background: The advanced lung cancer inflammation index (ALI) is an independent prognostic biomarker used to assess inflammation and nutritional status in various cancers, heart failure, and acute coronary syndromes. This study investigates the prognostic significance of ALI in patients experiencing ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), comparing its predictive abilities with the established Neutrophil-Lymphocyte Ratio (NLR). Methods: We conducted a retrospective analysis of 1171 patients from the Matrix Registry, encompassing demographic and clinical data for STEMI cases treated with pPCI, and ALI was determined using the formula [serum albumin (g/dL) × body mass index (kg/m²)]/NLR at the time of hospital admission. The primary outcome was all-cause mortality. Results: Of the 1171 patients, 86 died during the follow-up period. Univariate analysis identified age, female gender, smoking, hypertension, diabetes, prior myocardial infarction (PMI), lower left ventricular ejection fraction (LVEF), and reduced ALI as factors associated with mortality. Multivariate analysis confirmed age (HR: 1.1, 95% CI: 1.05–1.11, p < 0.001) and PMI (HR: 2.4, 95% CI: 1.4–4.3, p = 0.001) as prominent independent predictors, alongside ALI (HR: 0.95, 95% CI: 0.92–0.97, p < 0.001) and LVEF (HR: 0.98, 95% CI: 0.97–0.99, p = 0.04). An ALI cut-off of ≤10 indicated a higher mortality risk (HR: 2.3, 95% CI: 1.5–3.7, p < 0.001). The area under the curve for ALI (0.732) surpassed that for NLR (0.685), demonstrating ALI’s superior predictive capability. Conclusions: ALI is an independent prognostic factor for all-cause mortality in STEMI patients undergoing pPCI, showing greater discriminatory power than NLR, particularly in patients with ALI values ≤ 10, who face a 2.3-fold higher mortality risk. Full article

Objectives: We aimed to investigate the association between the triglyceride glucose index (TGI) and mortality in patients with ST-elevation myocardial infarction (STEMI). Methods: This retrospective study utilized data from the records of patients diagnosed with STEMI who underwent primary percutaneous coronary intervention (PCI) at the Cardiology Department of Private Aktif International Hospital between 2020 and 2023. Demographic data, medical history, laboratory results, and treatment processes of the patients were obtained from retrospective records. Patients were divided into low (TGI ≤ 8.6)-, medium (TGI = 8.6–9.2)-, and high (TGI ≥ 9.2)-TGI groups according to their TGI levels. Results: The average age of the patients was 62 ± 10 years, and 65% were men. The intracoronary thrombus burden of patients in the high-TGI group was found to be significantly higher compared to the low- and medium-TGI groups (p = 0.01). While the rate of patients with a thrombolysis in myocardial infarction (TIMI) thrombosis score of 3 or above was 45% in the high-TGI group, this rate was observed to be 20% in the low-TGI group. The short-term (30-day) mortality rate was found to be 15% in the high-TGI group, 8% in the medium-TGI group, and 5% in the low-TGI group (p = 0.02). Long-term (after 30 days) mortality rates were determined as 25% in the high-TGI group, 15% in the medium-TGI group, and 10% in the low-TGI group (p = 0.01). TGI was an independent risk factor for both short-term and long-term mortality. The hazard ratio (HR) of high TGI levels for short-term mortality was found to be 2.5 (95% CI: 1.5–4.1, p = 0.01), and the HR for long-term mortality was 2.0 (95% CI: 1.3–3.2, p < 0.02). Conclusions: Our results show that high TGI levels are associated with increased thrombus burden and high mortality rates in STEMI. TGI can be used not only in predicting STEMI but also in early risk stratification and treatment planning for STEMI patients. Full article

The aim of the study was to evaluate the prognostic value of the one-year dynamics of the new index START in patients with coronary artery disease after coronary artery bypass grafting (CABG). Methods. Patients with coronary artery disease (n = 196) whose START index was assessed before CABG and one year after surgery. Depending on the dynamics of the stiffness index, three groups of patients were identified: 1st—with a decrease in haSTART (n = 79, 40.3%), 2nd—without dynamics (n = 52, 26.5%), and 3rd. Patients were followed for 10 years, and groups were compared for all-cause death, myocardial infarction, stroke/transient ischemic attack, and a composite endpoint. Results. In the group with an increase in the haSTART index, type D personality was identified more often (53.8%) than in the group without changes in haSTAR (26.9%) or with a decrease in the haSTAR index (34.2%) (p = 0.008). In the long-term follow-up period, death from all causes was significantly more common in the group with an increase in haSTART (33.9%) and in the group without changes in haSTART (23.1%) than in the group with a decrease in haSTART (11.4%, p = 0.005). Patients with an increase in haSTART more often had MACE (death, MI, stroke/TIA)—in 47.7% of cases (p = 0.01), compared with patients with a decrease in haSTART (in 24.1% of cases) and without change in haSTART (by 30.8%). Kaplan–Meier curves revealed better long-term survival rates in the group with a decrease in the haSTART index (p = 0.024). Multivariate analysis showed that a decrease in the haSTART index one year after CABG was associated with a decrease in mortality (HR 0.462; 95% CI 0.210–1.016; p = 0.055). Conclusions. The dynamics of the haSTART arterial stiffness index one year after CABG has prognostic significance in the long-term follow-up period. In addition, in the group with an increase in the haSTART index, personality type D is more common. Further studies need to study which interventions in patients with coronary artery disease can cause favorable dynamics in the haSTART index and to what extent psychological characteristics can influence these dynamics. Full article

Breast cancer (BC) and depression are globally prevalent problems. Numerous reviews have indicated the high prevalence of depression among BC survivors. However, the long-term impact of depression on survival among BC survivors has not been well explored. For this investigation, we aimed to explore the relationship between BC, depression, and mortality from a national random sample of adult American women. Data from the U.S. National Health and Nutrition Examination Survey (years 2005–2010) were linked with mortality data from the National Death Index up to December 31st, 2019. A total of 4719 adult women (ages 45 years and older) were included in the study sample with 5.1% having breast cancer and more than a tenth (12.7%) having depression. The adjusted hazard ratio (HR) for all-cause mortality risk among those with BC was 1.50 (95% CI = 1.05–2.13) compared to those without BC. In the adjusted analysis, the risk of all-cause mortality was highest among women with both depression and BC (HR = 3.04; 95% CI = 1.15–8.05) compared to those without BC or depression. The relationship between BC and mortality was moderated by cardiovascular diseases, anemia, smoking, age, PIR, and marital status. Our analysis provides vital information on factors that could be helpful for interventions to reduce mortality risk among those with BC and depression. In addition, given the higher risk of mortality with co-occurring BC and depression, collaborative healthcare practices should help with widespread screening for and treatment of depression among BC survivors. Full article

Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) K. pneumoniae are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) K. pneumoniae (n = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (n = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC > 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS K. pneumoniae. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the K. pneumoniae were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing K. pneumoniae (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in mgrB or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, p ≤ 0.003). The widespread nature of CHR among MDR K. pneumoniae in our study urge the development of rapid HR detection methods to inform on the need for combination regimens. Full article

Background: The prevalence of long-COVID (LC) presents a significant challenge to healthcare systems globally. There are still some discrepancies on the role of sex as an independent risk factor of LC complications. Thus, we aimed to determine the differences in clinical and cardiovascular complications between males and females without comorbidities after COVID-19. Methods: Clinical data on the course of the disease with the accompanying symptoms and post-COVID-19 symptoms were compiled from both male and female subjects with a minimum 12-week interval after COVID-19 recovery. Next, the patients were followed for 12 months. ECG, echocardiography, 24 h ECG monitoring, 24 h ambulatory blood pressure monitoring (ABPM), and selected biochemical tests were performed. LC was diagnosed based on the World Health Organization (WHO) definition. To reduce the impact of confounders, i.e., body mass index (BMI) and age, on the results of the study, the nearest neighbour (NN) propensity score matching (PSM) method with a 1:1 ratio was used. Results: The results were obtained following the removal of cases with comorbidities from the database consisting of 1237 males and 2192 females, and PSM of the new database included 886 cases (443 males and 443 females). At both the 3-month and 1-year post-recovery marks, females consistently reported a higher frequency of LC symptoms compared to males (p < 0.001 for both comparisons). Moreover, after 1 year of follow-up, females exhibited a higher prevalence of LC compared to males, with rates of 14% versus 8.3%, respectively (p = 0.013). The symptoms that significantly differed between females and males in the 12-month follow-up were hair loss (5.4 vs. 0.7%, p < 0.001), memory and concentration disturbances (8.4 vs. 4.3%, p = 0.013), and headaches (4.3 vs. 1.4%, p = 0.008). Females presented lower mean arterial pressure (MAP) [89 (83–95) mmHg versus (vs.) 94 (89–100); p < 0.001] and lower pulse pressure (PP) [46 (42–52) mmHg vs. 51 (48–57); p < 0.001] in 24 h ABPM and more elevated heart rates (HRs) in 24 h ECG monitoring as well as arrhythmia (p < 0.001 and p = 0.018, respectively). Males had a higher occurrence of ECG abnormalities such as QRS >= 120 ms, ST-T changes, T inversion, arrhythmia, and QRS fragmentation (27.3% vs. 19.2%; p = 0.004). No significant differences were observed between males and females concerning physical activity levels, stress, fatigue, alcohol consumption, and smoking habits. Conclusions: One year post-COVID-19 recovery, regardless of age and BMI, healthy females more often suffered from LC symptoms than males. They had lower MAP and PP in 24 h ABPM, more often had higher HRs and arrhythmia in 24 h ECG monitoring, and fewer ECG abnormalities than males. Full article

(1) Background: The systemic inflammatory response index (SIRI; neutrophil count × monocyte/lymphocyte count), and the systemic immune-inflammation index (SII; platelet count × neutrophil count/lymphocyte count) are recently proposed biomarkers to assess the immune and inflammatory status. However, data on SIRI and SII are still relatively lacking and do not definitively and exhaustively define their role as predictors of an adverse prognosis in acute myocardial infarction (AMI). The aim of the present study was to evaluate SII and SIRI determinants as well as to assess SIRI and SII prognostic power in ST-elevation myocardial infarction (STEMI). (2) Methods: A total of 105 STEMI patients (74 males, 70 ± 11 years) were studied (median follow-up 54 ± 25 months, 24 deaths). (3) Results: The main determinants of SIRI and SII were creatinine and brain natriuretic peptide (BNP) (multivariate regression). Patients with higher SIRI (>75th percentile, 4.9) and SII (>75th percentile, 1257.5) had lower survival rates than those in the low SIRI/SII group (Kaplan–Meier analysis). Univariate Cox regression revealed that high SIRI and SII were associated with mortality (HR: 2.6, 95% CI: 1.1–5.8, p < 0.05; 2.2, 1–4.9, p ≤ 0.05, respectively); however, these associations lost their significance after multivariate adjustment. (4) Conclusions: SIRI and SII association with mortality was significantly affected by confounding factors in our population, especially creatinine and BNP, which are associated with both the inflammatory indices and the outcome. Full article