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Background and Aim:The systemic immune-inflammation index (SII) has been identified as a novel prognostic marker in various illnesses. We investigated the relationship between SII and mortality in patients undergoing primary percutaneous coronary intervention (pPCI). In addition, we planned to examine how SII correlated with SYNTAX II and thrombolysis in myocardial infarction (TIMI) risk scores in this population.Materials and Methods:This retrospective observational study included patients with ST-segment elevation myocardial infarction who underwent pPCI. The endpoint was 1 year all-cause mortality. SII [(neutrophil x platelet)/lymphocyte] was calculated from admission blood samples. Besides clinical and laboratory findings, SII, Syntax II and TIMI risk scores were compared between survivors and non-survivors. The correlation between SII and Syntax II and TIMI risk scores was also evaluated.Results:The study included 334 patients (82.3% male). In the 1 year follow-up, 18 patients (5.4%) died. The SII, Syntax II, and TIMI risk scores were significantly higher in non-survivors than in survivors [mean (standard deviation: SD), 2423 (2005) vs 1686 (998), P = 0.005; median (interquartile range) 43 (35-53) vs 30 (25-37), P < 0.001; and 4 (2-5) vs 2 (1-3), P = 0.005, respectively]. Furthermore, the Syntax II score, TIMI risk score, and SII was independent predictors of 1 year all-cause mortality. SII showed a significant correlation with Syntax II and TIMI risk scores (R2 = 0.28, P = 0.001 and R2 = 0.37, P < 0.001, respectively).Conclusion:SII might provide additional prognostic data alongside Syntax II and TIMI risk scores in patients undergoing pPCI.