Predictive Roles of Right Coronary Artery Disease Severity and Systemic Immune Inflammation Index in Predicting Atrial Fibrillation After Coronary Bypass Operations in Patients with Right Coronary Artery Disease

Abstract

Background: Postoperative atrial fibrillation (PoAF) is observed at a rate of 25-40% in the postoperative period after coronary artery bypass graft (CABG) surgery and can increase mortality, morbidity, and treatment costs. Inflammation and coronary artery disease (CAD) severity are important parameters to predict PoAF. Methods: Patients with right coronary artery (RCA) disease who underwent isolated CABG operation between January 1, 2017 and April 15, 2020, were included in the study retrospectively. Demographic features, preoperative total Gensini score (TGS), right coronary Gensini score (RCGS), systemic immune inflammation index (SII), and postoperative characteristics were recorded. Results: A total of 283 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 211, median age=60 (33-82) years), and those who did were included in Group 2 (N = 72, median age=68 (42-85) years). There were no statistically significant differences between the two groups, in terms of gender, hypercholesterolemia, cerebrovascular event/trans-ischemic attack history, body mass index, diabetes mellitus, smoking, beta blocker/angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, ejection fraction and left atrium diameters. As a result of multivariate analysis, advanced age (OR: 2.816 CI 95%: 1.687-3.498 P < .001), hypertension (OR:0.896, CI 95%: 0.578-0.965, P = .022), SII (OR: 1.548 CI 95%: 1.265-2.896, P = .003), TGS (OR: 1.235, CI 95%: 1.096-2.424, P = .012), and RCGS (OR: 2.112, CI 95%: 1.665-4.156, P < .001) values were determined as independent predictors for predicting postoperative atrial fibrillation. Conclusion: In this study, we showed that RCGS and SII values were independent predictors of PoAF after CABG operations in patients with right coronary artery disease.

Systemic immune–inflammation index for predicting postoperative atrial fibrillation following cardiac surgery: a meta-analysis

“…The majority of study participants were male, comprising 35.2%–78.4% of patients. Six studies enrolled patients undergoing CABG ( 14 , 20 , 21 , 29 – 31 ), whereas one study also included those undergoing other cardiac surgical procedures, including valve replacements ( 22 ). Another study only enrolled patients undergoing mitral valve surgery ( 19 ).…”

“…Patients who developed POAF had significantly higher SII values than those who did not, with a pooled MD of 493.53 (95% CI, 284.83–702.24; p < 0.00001) ( Figure 4 ) ( 19 – 21 , 29 – 31 ). The odds of developing POAF were 3.24-fold higher in patients with high SII levels (OR, 3.24; 95% CI, 1.6–6.55; p = 0.001) ( Figure 5 ) ( 14 , 19 , 20 , 22 ).…”

“…Subgroup analysis based on the type of surgical procedure, with a specific focus on cases in which only CABG was performed, is show in Figure 10A . These studies exclusively used preoperative SII values as a predictive tool for POAF ( 20 , 21 , 29 – 31 ). The pooled sensitivity and specificity of the SII for predicting POAF were 0.83 (95% CI, 0.67–0.92; I 2 = 88.13%) and 0.42 (95% CI, 0.12–0.8; I 2 = 98.96%), respectively.…”

Role of Systemic Immune-Inflammatory Index in Predicting the Development of In-Hospital Malignant Ventricular Arrhythmia in Patients With ST-Elevated Myocardial Infarction

“…[26][27][28][29] Also, there are recent publications showing that SII is associated with the development of atrial fibrillation (AF) in the postoperative period after coronary artery bypass grafting surgery. 30,31 However, there are no studies comparing inflammatory parameters in predicting the development of malignant ventricular arrhythmia (MVA). The aim of the present study is to investigate the relationship between inflammatory parameters and MVA development in STEMI patients.…”

Preoperative predictors of postoperative atrial fibrillation in patients undergoing cardiopulmonary bypass

“…Apart from these scoring systems, inflammatory parameters obtained from routine blood values are also used to predict the risk of PoAF 17,18 . The most popular of these is the neutrophil/lymphocyte ratio, and the systemic immune inflammation index obtained by the platelet count added to this formula has also been investigated and its predictive value has been shown 19,20 . Ata et al 21 reported in another study that preoperative high BNP levels and advanced age were important predictors for the development of POAF in patients who underwent isolated coronary bypass surgery (CABG) with CPB.…”