血糖水平对冠状动脉疾病（CAD）患者的临床预后有着显著影响，而全身免疫炎症是CAD和糖尿病的常见危险因素。然而，免疫炎症水平与不同葡萄糖代谢状态下CAD患者不良预后之间的关系尚不清楚。我们在2007年1月至2020年12月间招募了84645名CAD患者。全身免疫炎症指数（SII）被用来综合反映患者的免疫和炎症水平，计算公式如下：中性粒细胞数 × 血小板数/淋巴细胞数。根据其葡萄糖代谢状态（糖尿病[DM]、糖尿病前期[pre-DM]和正常葡萄糖调节[NGR]），将患者分为九组。我们使用Cox回归模型和竞争风险Fine and Gray模型研究了SII与临床结果之间的关联。在随访期间，共有12578名患者死亡，其中包括5857例与心血管有关的死亡和1251例与癌症有关的死亡。无论在NGR、pre-DM和DM的CAD患者中，随着SII分组的增加，所有因素和特定原因的死亡风险都增加。考虑到葡萄糖代谢状态，多元Cox回归显示，CAD患者的DM组和SII-H水平具有最高的全因死亡风险（1.69 [1.56-1.83]），心血管死亡风险（2.29 [2.02-2.59]）和癌症死亡风险（1.29 [1.01-1.66]）。此外，将SII纳入传统危险因素模型中可以显著改善对全因死亡和心血管死亡的预测的C指数。入院时的全身免疫炎症水平与CAD患者的全因死亡和特定原因死亡的风险增加相关，尤其是对于患有DM的患者。© 2023 徐等。

Blood glucose levels significantly affect the clinical prognosis of patients with coronary artery disease (CAD), and systemic immune inflammation is a common risk factor for both CAD and diabetes. However, the relationship between immune inflammation levels and poor prognosis in patients with CAD with different glucose metabolic statuses remains unclear.Between January 2007 and December 2020, we recruited 84,645 patients with CAD. The systemic immune inflammation index (SII) was used to comprehensively reflect the immune and inflammatory levels of patients and was calculated using the following formula: neutrophils × platelets/lymphocytes. The patients were classified into nine groups according to their glucose metabolism status (diabetes mellitus [DM], pre-diabetes mellitus [pre-DM], and normal glucose regulation [NGR]). Cox regression models and competing risk Fine and Gray models were used to investigate the association between SII and clinical outcomes.During the follow-up period, 12,578 patients died, including 5857 cardiovascular-related and 1251 cancer-related deaths. The risk of all-cause and cause-specific mortality increased with increasing SII tertiles in CAD patients with NGR, pre-DM, and DM. When considering glucose metabolism status, the multivariate cox regression revealed that CAD patients with DM and SII-H levels had the highest risk of all-cause mortality (1.69 [1.56-1.83]), cardiovascular mortality (2.29 [2.02-2.59]), and cancer mortality (1.29 [1.01-1.66]). Moreover, incorporating the SII into traditional risk factor models significantly improved the C-index for predicting all-cause and cardiovascular mortality.Systemic immune inflammation levels on admission were correlated with a higher risk of all-cause and cause-specific mortality in patients with CAD, particularly in those with DM.© 2023 Xu et al.