Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization

Abstract

Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59–64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17–17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001).

Large unstained cell (LUC) count as a predictor of carotid artery occlusion

“…[33][34][35] Simple parameters from whole blood count, including NLR, MLR and SIRI, were postulated to be related to atherosclerosis progression. [36][37][38][39][40][41][42] However, in our analysis, none of these indices were related to carotid artery occlusion, although we previously presented the prognostic value of MLR for collateral carotid artery involvement. 32 The significant difference between LUCs and lymphocyte, monocyte and neutrophil counts is based on the characteristics of the cells; LUC counts take into account activated cells, while other cell counts measure the concentration of the cells.…”

Predictive value of systemic inflammatory response index (SIRI) for complex coronary artery disease occurrence in patients presenting with angina equivalent symptoms

“…This is the first analysis, according to available research, proposing identification of those patients presenting with angina pectoris equivalent symptoms who may require coronary angiography. Fatigue is a symptom which is often reported as secondary to diagnosed CAD and is related to distress syndrome [38].…”

Neutrophil and lymphocyte count as predictors of the location of calcific coronary lesions in patients treated with rotational atherectomy

“…Particularly, the understanding of individual patients' differences in degree of inflammatory activation and its influence on long-term outcomes of the disease and interventional therapy is still lacking. Our previous reports [23,24] have already proved that increased pre-procedural inflammatory activation, evaluated with simple indexes, may have good predictive value for the assessment of long-term survival or mortality. Thus, we suggest that some individual inflammatory characteristics may result in different responses to medical therapy.…”