Department of Cardio-Thoracic Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Immunol. 2023 Aug 14;14:1190380. doi: 10.3389/fimmu.2023.1190380. eCollection 2023.
Inflammation plays an integral role in the development of cardiovascular disease, and few studies have identified different biomarkers to predict the prognosis of cardiac surgery. But there is a lack of reliable and valid evidence to determine the optimal systemic inflammatory biomarkers to predict prognosis.
From December 2015 and March 2021, we collected 10 systemic inflammation biomarkers among 820 patients who underwent cardiac surgery. Time-dependent receiver operating characteristic curves (ROC) curve at different time points and C-index was compared at different time points. Kaplan-Meier method was performed to analyze overall survival (OS). Cox proportional hazard regression analyses were used to assess independent risk factors for OS. A random internal validation was conducted to confirm the effectiveness of the biomarkers.
The area under the ROC of lymphocyte-to-C-reactive protein ratio (LCR) was 0.655, 0.620 and 0.613 at 1-, 2- and 3-year respectively, and C-index of LCR for OS after cardiac surgery was 0.611, suggesting that LCR may serve as a favorable indicator for predicting the prognosis of cardiac surgery. Patients with low LCR had a higher risk of postoperative complications. Besides, Cox proportional hazard regression analyses indicated that LCR was considered as an independent risk factor of OS after cardiac surgery.
LCR shows promise as a noteworthy representative among the systemic inflammation biomarkers in predicting the prognosis of cardiac surgery. Screening for low LCR levels may help surgeons identify high-risk patients and guide perioperative management strategies.
炎症在心血管疾病的发展中起着重要作用，很少有研究确定不同的生物标志物来预测心脏手术的预后。但是，缺乏可靠和有效的证据来确定最佳的全身性炎症生物标志物来预测预后。
从 2015 年 12 月至 2021 年 3 月，我们收集了 820 例接受心脏手术的患者中的 10 种系统性炎症生物标志物。比较了不同时间点的时间依赖性接受者操作特征曲线（ROC）曲线和 C 指数。采用 Kaplan-Meier 法分析总生存率（OS）。使用 Cox 比例风险回归分析评估 OS 的独立危险因素。采用随机内部验证法验证生物标志物的有效性。
淋巴细胞与 C 反应蛋白比值（LCR）的 ROC 曲线下面积在 1、2 和 3 年时分别为 0.655、0.620 和 0.613，LCR 对心脏手术后 OS 的 C 指数为 0.611，提示 LCR 可能是预测心脏手术后预后的有利指标。LCR 较低的患者术后并发症风险较高。此外，Cox 比例风险回归分析表明，LCR 是心脏手术后 OS 的独立危险因素。
LCR 作为预测心脏手术预后的全身性炎症生物标志物中一个有前途的代表性指标。筛查低 LCR 水平可能有助于外科医生识别高危患者，并指导围手术期管理策略。
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