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

Tomasz Urbanowicz1, Anna Olasińska-Wiśniewska1, Michał Michalak2

  • 1Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland.

Plos One
|December 15, 2022
PubMed

Insights

Preoperative inflammatory markers, specifically the systemic inflammatory response index (SIRI), can predict long-term survival after off-pump coronary artery bypass grafting for complex coronary artery disease.

Area of Science:

  • Cardiovascular Surgery
  • Inflammation Biology
  • Prognostic Biomarkers

Background:

  • Coronary artery bypass grafting (CABG) remains a primary treatment for complex coronary artery disease.
  • The link between postoperative inflammation and long-term outcomes is recognized.
  • Predictive inflammatory markers before off-pump CABG require further investigation.

Purpose of the Study:

  • To evaluate the predictive role of preoperative inflammatory indexes in long-term survival after off-pump CABG.
  • To assess the prognostic value of whole blood count-derived inflammatory markers.

Main Methods:

  • Retrospective analysis of 171 patients undergoing off-pump CABG (Jan-Dec 2014).
  • 8-year follow-up for overall survival.
  • Multivariable analysis of preoperative and postoperative inflammatory markers, including the systemic inflammatory response index (SIRI).

Main Results:

  • Overall survival was 80% over 8 years, with 34 deaths (1% 30-day mortality).
  • A preoperative SIRI > 1.27 was a significant predictor of long-term mortality (HR = 6.16, p = 0.012).
  • The SIRI demonstrated prognostic value for late mortality after off-pump CABG (AUC = 0.682, p < 0.001).

Conclusions:

  • Preoperative inflammatory activation, assessed by SIRI, is a valuable prognostic indicator for patients with complex coronary artery disease.
  • Elevated preoperative SIRI (>1.27) suggests a poorer long-term prognosis following off-pump CABG.
  • SIRI can aid in risk stratification for patients undergoing off-pump coronary artery bypass surgery.

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