Integration of the systemic inflammatory response index with pulse pressure enhances prognostication of cardiovascular mortality in the general population of the United States: insights from the NHANES database

BackgroundThe prognostic significance of utilizing both the systemic inflammatory response index (SIRI) and pulse pressure (PP) collectively in assessing cardiovascular mortality (CVM) across populations remains to be elucidated.MethodsMultivariate Cox proportional hazards analysis investigated the SIRI, PP, and CVM association. Receiver operating characteristic (ROC) curves evaluated the predictive performance of the combined SIRI and PP for CVM in the broader demographic. Subsequently, the area under the ROC curve (AUC) was compared using the Z-test, and a novel nomogram was developed to assess its accuracy in predicting CVM. Restricted cubic spline (RCS) was used to evaluate the association between SIRI and PP.ResultsThe study involved 19,086 NHANES database individuals, with 9,531 males (49.94%). During the follow-up period, 456 CVM instances (2.39%) occurred. Multivariate Cox proportional hazards analysis revealed both the SIRI [adjusted hazard ratio (HR) 1.16, P