The systemic-immune-inflammation index predicts the recurrence of atrial fibrillation after cryomaze concomitant with mitral valve surgery

Abstract

Background and aims Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). The systemic inflammation indexes are easily evaluated and predict AF development. However, it’s role in prediction of recurrence of AF is unknown. We aim to explore the association between the systemic inflammation indexes and recurrence of AF in patients underwent cryoablation (CryoMaze) concomitant with mitral valve surgery. Methods We examined systemic inflammation indexes during perioperative period in 122 patients between 2015 and 2018. Systemic inflammation indexes were developed by systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocytes to monocytes ratio. Univariate and multivariate analyses were performed to examine the association of each markers with recurrence of AF. Results Of the 122 patients included in this study, 22 patients (18%) experienced AF recurrence after CryoMaze concomitant with mitral valve surgery. There is no significant difference between each systemic inflammation indexes before surgery and recurrence of AF. In univariate analysis, MLR after surgery 3 days, PLR, MPLR, NLR, SII after surgery 7 days were able to predict recurrence of AF. In multivariate analyses, SII ≥ 1696 independently predicted recurrence (OR, 3.719; 95% CI, 1.417–9.760). Interestingly, baseline SII showed no significant in prediction of recurrence. It was sharply elevated after surgery and dropped slowly. In patients of recurrence, SII after 7 days of surgery increased again. Conclusions The raised SII again was associated with an increased risk of the postoperative recurrence of AF and independently predicted the late recurrence of AF after CryoMaze concomitant with mitral valve surgery.

Prognostic Value of Systemic Immune-Inflammation Index among Critically Ill Patients with Acute Kidney Injury: A Retrospective Cohort Study

“…SII may be valuable for the prognosis evaluation of AKI patients with atrial fibrillation or hypertension, but seemed to be of weak prognostic value for AKI patients with CKD, chronic liver disease and hepatic failure. Similarly, the previous study also showed that raised SII was associated with an increased risk of the postoperative recurrence of atrial fibrillation and independently predicted the recurrence of atrial fibrillation after cryoablation concomitant with mitral valve surgery (OR, 3.719; 95% CI, 1.417-9.760) [44]. Although there was no research on the correlation between SII and hypertension, the interconnection of inflammation and the pathogenesis of hypertension has been recognized [45,46].…”

Investigation of the Associations of Novel Inflammatory Biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)—With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence

“…SII employs three blood cell subtypes (neutrophils, lymphocytes, and platelets), reflecting the balance between inflammation and the immune response to it [ 22 , 23 ]. In cardiac patients, elevated SII was associated with an increased risk of CAD and its greater severity [ 24 , 25 , 26 ], as well as a worse development of collateral circulation in heart muscle [ 27 ] or a higher risk of major adverse cardiovascular events (MACE) in patients with heart failure [ 28 ] after coronary intervention [ 29 , 30 ] or cardiosurgery [ 31 , 32 , 33 , 34 ]. SII was also described as an independent predictor of massive pulmonary embolism [ 35 ], a contrast-induced nephropathy risk factor in patients undergoing coronary angiography [ 36 , 37 ], a risk factor for postoperative and recurrent atrial fibrillation after cardiac surgery [ 38 ], as well as for developing patent systolic dysfunction in postpartum cardiomyopathy [ 39 ].…”

The Association between Serum Vitamin D Concentration and New Inflammatory Biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response (SIRI)—In Patients with Ischemic Heart Disease

“…In cardiology, high SIRI was correlated with an increased risk of ACS in patients with chest pain [ 21 ], supraventricular tachycardia in patients with stroke [ 22 ], and major adverse cardiovascular events (MACE) in patients after ACS treated with percutaneous intervention (PCI) [ 23 ]. SII was associated with an increased risk of MACE in patients with heart failure [ 24 ], after cardiosurgery [ 25 , 26 , 27 , 28 ], and after PCI [ 23 , 29 ]. It was also described to be correlated with collateral circulation development [ 30 ], contrast-induced nephropathy [ 31 , 32 ], massive pulmonary thrombosis risk [ 33 ], and coronary artery disease diagnosis and its severity [ 21 , 34 , 35 , 36 ].…”