The Role of Systemic Immune Inflammation Index for Predicting Saphenous Vein Graft Disease in Patients with Coronary Artery Bypass Grafting

Abstract

As inflammation plays a significant role in the development of coronary artery disease, we hypothesized that there may be a relation between the systemic immune inflammation index (SII) and saphenous vein graft disease (SVGD). The study population consisted of 716 consecutive patients who underwent elective coronary angiography (CAG) >1 year after bypass grafting. The patients were divided into 2 groups depending on the extent of SVG patency. SII value was significantly higher in the SVGD(+) group compared with the SVGD(−) group ( P < .001). In multivariate logistic regression analysis, SII ( P < .001, odds ratio (OR) = 3.27, 95% CI = 1.94–5.65) and neutrophil-to-lymphocyte ratio (NLR) ( P < .001, OR = 2.08, 95% CI = 1.59–3.11) were found to be independent predictors of SVGD. An SII value of >935 (x103/ml) has 89.2% sensitivity and 70.6% specificity for the prediction of the SVGD, and an NLR value of >4.15 has 54.6% sensitivity and 68.5% specificity for the prediction of the SVGD. The AUC of SII was found to be greater than the AUC of NLR ( P = .002), platelet-to-lymphocyte ratio (PLR) ( P = .009), lymphocyte-to-monocyte ratio (LMR) ( P = .013), MPV ( P = .011), and C-reactive protein (CRP) ( P = .034) in predicting SVGD. In conclusion, we demonstrated that SII, which is among the new inflammation indexes, is a more reliable predictor in determining SVGD than the NLR, PLR, and LMR.

Use of machine learning to identify risk factors for coronary artery disease

“…Furthermore, multiple genetic and sociological studies have found that family history is a significant risk factor for coronary artery disease [37][38][39][40]. Additionally, low-platelets being associated with coronary artery disease is associated with pathology such as thrombocytopenia [41][42][43]. In addition to the top four covariates within our model, we also wanted to explore if the machine-learning model was able to generate predictions for HDL-Cholesterol and Systolic Blood pressure, two major risk factors that have been widely studied within the cardiovascular literature.…”

The Significance of Simple Inflammatory Markers in Off Pump Surgery—Review

“…Systemic index >545 × 10 3 /mm 3 was proposed as postoperative atrial fibrillation risk factor (OR: 10.2; 95% CI: 5.1-20.2, p < 0.001; AUC: 0.91) in on pump surgical revascularization by Honue et al [123]. Dogdus et al [100] in their analysis presented SII value >935 × 10 3 /mL as a better saphenous vein graft predictor than NLR (OR: 3.27, 95% CI: 1.94-5.65, p < 0.001).…”

Late Saphenous Vein Graft Disease: Cut to the Chase

“…The authors 1 included 716 consecutive patients who underwent elective coronary angiography >1 year after coronary artery bypass grafting (CABG). They investigated the role of the systemic immune inflammation index (SII) in predicting the development of saphenous vein graft disease (SVGD) in these patients.…”

“…6 A significant correlation was shown with the SYNTAX score in patients with coronary artery disease. 6 Could the high SII values in the study 1 be related to the high SYNTAX score? Moreover, atherosclerosis is a systemic disease.…”

“…In their multivariate analysis, the authors identified SII and neutrophil-lymphocyte ratio (NLR) as independent predictors of SVGD. 1 The SII value is obtained by multiplying the NLR value with the platelet count. The inclusion of two variables with common content in the same multivariate analysis may be misleading.…”