Saskin Hüseyin, Serhan Ozcan Kazim, Yilmaz Seyhan
Department of Cardiovascular Surgery, Derince Training and Research Hospital, Kocaeli, Turkey.
Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey.
Interact Cardiovasc Thorac Surg. 2017 Mar 1;24(3):395-401. doi: 10.1093/icvts/ivw376.
The monocyte to high-density lipoprotein ratio has recently emerged as an indicator of inflammation and oxidative stress. The aim of this study was to evaluate the association of the monocyte to high-density lipoprotein ratio with postoperative atrial fibrillation and mortality in coronary artery bypass grafting.
Six hundred and sixty-two patients who were in sinus rhythm preoperatively and who had isolated coronary artery bypass grafting were retrospectively included in the study. Patients who had atrial fibrillation in the early postoperative period were enrolled in group 1 ( n = 153); patients who remained in sinus rhythm in the early postoperative period were included in group 2 ( n = 509). The clinical and demographic data of the patients, biochemical and complete blood count parameters, preoperative monocyte count/high-density lipoprotein cholesterol ratio, and operative and postoperative data were recorded.
Preoperative monocyte counts ( P = 0.0001), monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.0001) and C-reactive protein levels ( P = 0.0001) were significantly increased in group 1. In the first month, 8 patients in group 1 (5.2%) and 5 patients in group 2 (1.0%) died, which was statistically significant ( P = 0.003). In univariate and multivariate logistic regression analyses, an elevated preoperative monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.03) and C-reactive protein levels ( P = 0.0001) were predictors of postoperative atrial fibrillation. Preoperative monocyte counts ( P = 0.001), monocyte count/high-density lipoprotein cholesterol ratio ( P = 0.0001) and the use of inotropic support ( P = 0.0001) were also predictors of mortality in the early postoperative period.
We have observed that high preoperative monocyte count/ high-density lipoprotein ratio was associated with postoperative atrial fibrillation and mortality after coronary artery bypass grafting operation.
单核细胞与高密度脂蛋白比值最近已成为炎症和氧化应激的一个指标。本研究的目的是评估单核细胞与高密度脂蛋白比值与冠状动脉搭桥术后房颤及死亡率之间的关联。
本研究回顾性纳入了662例术前为窦性心律且接受单纯冠状动脉搭桥术的患者。术后早期发生房颤的患者纳入第1组（n = 153）；术后早期维持窦性心律的患者纳入第2组（n = 509）。记录患者的临床和人口统计学数据、生化及全血细胞计数参数、术前单核细胞计数/高密度脂蛋白胆固醇比值以及手术和术后数据。
第1组患者术前单核细胞计数（P = 0.0001）、单核细胞计数/高密度脂蛋白胆固醇比值（P = 0.0001）和C反应蛋白水平（P = 0.0001）显著升高。在第一个月，第1组有8例患者（5.2%）死亡，第2组有5例患者（1.0%）死亡，差异有统计学意义（P = 0.003）。在单因素和多因素逻辑回归分析中，术前单核细胞计数/高密度脂蛋白胆固醇比值升高（P = 0.03）和C反应蛋白水平升高（P = 0.0001）是术后房颤的预测因素。术前单核细胞计数（P = 0.001）、单核细胞计数/高密度脂蛋白胆固醇比值（P = 0.0001）以及使用血管活性药物支持（P = 0.0001）也是术后早期死亡率的预测因素。
我们观察到术前单核细胞计数/高密度脂蛋白比值升高与冠状动脉搭桥术后房颤及死亡率相关。
