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全身免疫炎症指数作为非体外循环冠状动脉旁路移植术后心房颤动的新型预测因子。

Systemic immune-inflammation index as a novel predictor of atrial fibrillation after off-pump coronary artery bypass grafting.

机构信息

Bursa City Hospital, Department of Cardiology - Bursa, Turkey.

Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Cardiovascular Surgery - Bolu, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 Sep;68(9):1240-1246. doi: 10.1590/1806-9282.20220295.

Abstract

OBJECTIVE

This study aims to examine the predictive role of systemic immune-inflammation index on postoperative new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting.

METHODS

A total of 722 patients undergoing elective off-pump coronary artery bypass grafting between January 2017 and September 2021 were included in this study and divided into two groups as the atrial fibrillation group (n=172) and the non-atrial fibrillation group (n=550). Both groups were compared in terms of patients' baseline clinical features, operative and postoperative variables, and preoperative hematological indices derived from the complete blood count analysis. Multivariate logistic regression and receiver-operating characteristic curve analyses were performed to detect the independent predictors of postoperative new-onset atrial fibrillation.

RESULTS

The median age and length of hospital stay in the atrial fibrillation group were significantly higher than those in the non-atrial fibrillation group. The median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammation in the atrial fibrillation group were significantly greater than in those in the non- atrial fibrillation group. Logistic regression analysis demonstrated that age, platelet, platelet/lymphocyte ratio, and systemic immune-inflammation were independent predictors of postoperative new-onset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7×103/mm3 constituted cut-off value to predict the occurrence of new-onset atrial fibrillation with 86.6% sensitivity and 29.3% specificity.

CONCLUSION

Our study revealed for the first time that systemic immune-inflammation predicted new-onset atrial fibrillation after off-pump coronary artery bypass grafting.

摘要

目的

本研究旨在探讨全身免疫炎症指数对非体外循环冠状动脉旁路移植术后新发心房颤动的预测作用。

方法

本研究纳入 2017 年 1 月至 2021 年 9 月期间接受择期非体外循环冠状动脉旁路移植术的 722 例患者,分为心房颤动组(n=172)和非心房颤动组(n=550)。比较两组患者的基线临床特征、手术和术后变量以及全血细胞分析得出的术前血液学指标。采用多变量逻辑回归和受试者工作特征曲线分析来检测术后新发心房颤动的独立预测因子。

结果

心房颤动组的中位年龄和住院时间明显长于非心房颤动组。心房颤动组的白细胞、血小板、中性粒细胞、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值和全身免疫炎症的中位数明显高于非心房颤动组。Logistic 回归分析表明,年龄、血小板、血小板/淋巴细胞比值和全身免疫炎症是术后新发心房颤动的独立预测因子。受试者工作特征曲线分析显示,全身免疫炎症指数 706.7×103/mm3 预测新发心房颤动的截断值,其敏感性为 86.6%,特异性为 29.3%。

结论

本研究首次表明全身免疫炎症可预测非体外循环冠状动脉旁路移植术后新发心房颤动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca4/9575030/e4856680a053/1806-9282-ramb-68-09-1240-gf01.jpg

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