People with primary biliary cholangitis (PBC) face a meaningful risk of cardiovascular disease, and a simple blood-based inflammation score may help identify those at greatest danger, according to new research published recently in the European Journal of Medical Research.
This study found that higher levels of the systemic inflammatory response index (SIRI) were strongly tied to the presence of heart and blood vessel disease, even after accounting for other health factors.
“Given the complex interplay between immune activation and inflammation in patients with PBC, SIRI may be a promising biomarker to improve [cardiovascular disease] risk assessment,” explained this study’s authors.
Researchers studied 420 patients with PBC treated at Beijing Ditan Hospital between 2018 and 2022. Cardiovascular disease was present in 16.9% of patients, or 71 individuals. Those with heart disease were older, with a median age of 58 years (compared with 53 years for those without heart disease), and more likely to have diabetes, smoke or drink alcohol. They also had lower hemoglobin levels and higher measures of inflammation, including SIRI.
Read more about the prognosis in PBC
SIRI combines counts of neutrophils, monocytes and lymphocytes from routine blood tests to reflect immune activity and inflammation. Each standard deviation increase in SIRI was linked to a 79.2% higher odds of cardiovascular disease. This association held true after adjusting for weight, blood pressure, diabetes and other lab results.
When researchers compared several inflammation markers, SIRI performed best at predicting cardiovascular disease. A clear linear relationship was seen: as SIRI increased, so did heart disease risk.
Risk rose sharply when SIRI exceeded 0.65. Patients above this level had a cardiovascular disease rate of 24.8% compared with 9.0% in those below it. The link between SIRI and heart disease was especially strong in patients aged 65 years or older and in those with cirrhosis.
For patients, these results highlight why heart health matters in PBC. Chronic inflammation from this autoimmune liver disease may quietly strain the heart and blood vessels. A routine blood test could help flag higher risk earlier, giving patients and clinicians a chance to focus on lifestyle changes, control diabetes or blood pressure and consider closer cardiovascular monitoring before serious problems develop.
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