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Predictive Value of Preoperative Morphology Parameters in Patients Undergoing On-Pump and Off-Pump Coronary Artery
Krzysztof Greberski1,2, Jakub Batko3, Paweł Bugajski1,2
1Faculty of Health Sciences, University of Medical Sciences, 60-572 Poznan, Poland.
Insights
Certain blood morphological parameters like abnormal platelet-to-lymphocyte ratio (PLR), red blood cell distribution width (RDW-SD), and neutrophil-to-lymphocyte ratio (NLR) predict mortality after coronary artery bypass grafting (CABG). Abnormal lymphocyte counts predict late mortality.
Area of Science:
- Cardiology
- Hematology
- Surgical Outcomes Research
Background:
- Coronary heart disease (CHD) is a leading global cause of mortality, particularly in individuals over 35.
- Predicting postoperative mortality in patients undergoing Coronary Artery Bypass Grafting (CABG) is critical.
- Biomarkers are under investigation for their prognostic value in CABG patients.
Purpose of the Study:
- To evaluate the predictive capability of specific blood morphological parameters.
- To assess these parameters in both standard CABG and off-pump coronary artery bypass grafting (OPCAB) procedures.
Main Methods:
- A retrospective analysis of 520 patients undergoing CABG (404) or OPCAB (116).
- Data collected included demographics, comorbidities, survival rates, and preoperative blood samples.
- Inverse propensity treatment weighting was used to control for baseline confounding factors.
Main Results:
- No significant difference in outcomes was observed between isolated CABG and OPCAB groups.
- Abnormal red blood cell distribution width (RDW-SD), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were linked to increased mortality at one and five years.
- Abnormal lymphocyte counts were associated with increased late mortality.
Conclusions:
- Elevated PLR, RDW-SD, and NLR are significant predictors of both early and late mortality in patients undergoing CABG and OPCAB.
- Abnormal lymphocyte counts specifically predict late mortality in these patient populations.
Background:
Coronary heart disease is the most common cause of death worldwide. It is responsible for almost a third of deaths in patients over the age of 35. Various biomarkers are currently being studied in detail for their value in predicting postoperative mortality in patients undergoing CABG.
Aim:
The aim of this study is to analyze the predictive value of certain blood morphological parameters in CABG and off-pump coronary artery bypass grafting (OPCAB).
Methods:
A total of 520 patients who underwent surgery in two consecutive years and underwent CABG (404) or OPCAB (116) were included in this retrospective study. Gender, age, comorbidities, five-year survival rate, detailed information on hospitalization, surgery, intensive care unit parameters and preoperative blood samples from the cubital vein were recorded. Inverse propensity treatment weighting was applied to adjust for confounding factors at baseline.
Results:
No differences were found between OPCAB and CABG as an isolated comparison. In the standardized population, patients with abnormal lymphocyte counts had an increased risk of death at one-year and five-year follow-up. In the standardized population, abnormal red blood cell distribution width (RDW-SD), neutrocyte-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were associated with increased mortality in each period analyzed.
Conclusions:
Abnormal PLR, RDW-SD and NLR are associated with increased early and late mortality in patients undergoing CABG and OPCAB. Abnormal lymphocytes are only associated with increased late mortality.
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