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

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 immuneinflammation 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 newonset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7×10 3 /mm 3 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.

Circulating Levels of Ferritin, RDW, PTLs as Predictive Biomarkers of Postoperative Atrial Fibrillation Risk after Cardiac Surgery in Extracorporeal Circulation

“…Two recent studies [16,17] have, indeed, demonstrated significant associations between RWD, the sensitive marker of increased red cells turnover [18,19], and AF in general populations. In addition, Topal and coworkers [20] have recently proved that the median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, resulted significantly greater in cases with AF and undergoing off-pump coronary artery bypass grafting than in those in the non-AF group. Likewise, Sayin and coworkers [21] have also documented that PLT counts accompanied by the evaluation of other immune-inflammatory indexes can predict new onset AF in cases affected by acute coronary syndrome.…”

Circulating Levels of Ferritin, RDW, PTLs as Predictive Biomarkers of Postoperative Atrial Fibrillation Risk after Cardiac Surgery in Extracorporeal Circulation

“…Open heart surgery and CECC, however, contribute to evocating local and systemic inflammation. Systemic inflammation can cause diminished visceral blood flow resulting in mucosal ischemia, edema, and impaired mucosal transport [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Concerning local inflammation, research performed over the past 5 years evidence that atrial cardiomyocytes have diverse inflammatory signaling pathways that are demonstrated to be activated in both animal models and AF patients [ 12 , 13 , 14 , 15 , 16 , 17 ].…”

“…Systemic inflammation can cause diminished visceral blood flow resulting in mucosal ischemia, edema, and impaired mucosal transport [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Concerning local inflammation, research performed over the past 5 years evidence that atrial cardiomyocytes have diverse inflammatory signaling pathways that are demonstrated to be activated in both animal models and AF patients [ 12 , 13 , 14 , 15 , 16 , 17 ]. Such growing evidence on the crucial role of inflammation in POAF has also led to investigations on hematological indices as potential prognostic and predictive biomarkers for POAF.…”

“…Such growing evidence on the crucial role of inflammation in POAF has also led to investigations on hematological indices as potential prognostic and predictive biomarkers for POAF. Hematological indices are obtained from complete blood count test, and comprise white blood cell (WBC), red cell distribution width (RDW), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII), a novel biomarker that develops on platelet count and NLR (SII = platelets count × NLR) [ 17 , 18 ]. Interesting associations have been demonstrated with POAF developed after CABG treatment [ 17 , 18 ].…”

“…Hematological indices are obtained from complete blood count test, and comprise white blood cell (WBC), red cell distribution width (RDW), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII), a novel biomarker that develops on platelet count and NLR (SII = platelets count × NLR) [ 17 , 18 ]. Interesting associations have been demonstrated with POAF developed after CABG treatment [ 17 , 18 ]. Other blood factors have been evaluated in POAF patients as the parameters related to iron status detected at preoperative and postoperative times [ 19 ].…”