Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Department of Computer Science and Statistics, Poznan University of Medical Sciences, 61-806 Poznan, Poland.
Cells. 2022 Mar 26;11(7):1124. doi: 10.3390/cells11071124.
Background: Several perioperative inflammatory markers are postulated to be significant factors for long-term survival after off-pump coronary artery bypass surgery (OPCAB). Hematological parameters, whether single or combined as indices, provide higher predictive values. Methods: The study group comprised 538 consecutive patients (125 (23%) females and 413 (77%) males) with a mean age of 65 ± 9 years, who underwent OPCAB with a mean follow-up time of 4.7 ± 1.7 years. This single-center retrospective analysis included perioperative inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and systemic inflammatory index (SII). Results: Multivariable analysis identified levels of neutrophils above 4.3 × 109/L (HR 13.44, 95% CI 1.05−3.68, p = 0.037), values of SIRI above 5.4 (HR 0.29, 95% CI 0.09−0.92, p = 0.036) and values of NLR above 3.5 (HR 2.21, 95% CI 1.48−3.32, p < 0.001) as being significant predictors of long-term mortality. The multifactorial models revealed the possibility of strong prediction by combining preoperative factors (COPD, stroke, PAD, and preoperative PLR) and postoperative neutrophil counts (p = 0.0136) or NLR (p = 0.0136) or SIRI (p = 0.0136). Conclusions: Among the postoperative inflammatory indices, the levels of neutrophils, NLR, and SIRI are the most prominent markers for long-term survival after off-pump coronary artery bypass surgery, when combined with preoperative characteristics.
几种围手术期炎症标志物被认为是体外循环冠状动脉旁路移植术（OPCAB）后长期生存的重要因素。血液学参数，无论是单一参数还是联合作为指标，都提供了更高的预测值。方法：研究组包括 538 例连续患者（125 例（23%）女性和 413 例（77%）男性），平均年龄为 65±9 岁，接受 OPCAB 治疗，平均随访时间为 4.7±1.7 年。这项单中心回顾性分析包括围手术期炎症标志物，如中性粒细胞与淋巴细胞比值（NLR）、全身炎症反应指数（SIRI）、全身炎症综合指数（AISI）和全身炎症指数（SII）。结果：多变量分析确定了中性粒细胞水平高于 4.3×109/L（HR 13.44，95%CI 1.05−3.68，p = 0.037）、SIRI 值高于 5.4（HR 0.29，95%CI 0.09−0.92，p = 0.036）和 NLR 值高于 3.5（HR 2.21，95%CI 1.48−3.32，p < 0.001）是长期死亡率的显著预测因子。多因素模型显示，结合术前因素（COPD、中风、PAD 和术前 PLR）和术后中性粒细胞计数（p = 0.0136）或 NLR（p = 0.0136）或 SIRI（p = 0.0136）具有很强的预测可能性。结论：在术后炎症指标中，中性粒细胞、NLR 和 SIRI 水平是 OPCAB 术后长期生存的最显著标志物，与术前特征相结合。
