Related Experiment Video
Updated: May 28, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Delta Neutrophil Index in Coronary Artery Bypass Surgery: An Innovation in Postoperative Mortality Assessment
Abdulkadir Bilgiç1, Burak Toprak2, Hamide Kaya3
1Department of Cardiovascular Surgery, Mersin University Faculty of Medicine Hospital, Mersin, Turkey.
Insights
The Delta Neutrophil Index (DNI) is a strong predictor of early death after coronary artery bypass grafting (CABG). Elevated DNI levels, both before and after surgery, significantly increase mortality risk in CABG patients.
Area of Science:
- Cardiovascular Surgery
- Inflammatory Markers
- Prognostic Biomarkers
Background:
- Assessing coronary artery disease (CAD) severity often involves inflammatory markers.
- Existing biomarkers like CRP and WBC have limitations in predicting postoperative mortality after CABG.
- The Delta Neutrophil Index (DNI) shows promise as a specific indicator of acute inflammatory response.
Purpose of the Study:
- To evaluate the Delta Neutrophil Index (DNI) as a prognostic marker for early mortality in patients undergoing CABG.
- To determine the significance of both preoperative and postoperative DNI levels in predicting outcomes for CABG patients.
Main Methods:
- Retrospective cohort study of 446 patients undergoing CABG.
- Data collected from January 2022 to August 2023 at a tertiary cardiovascular surgery center.
- Analysis focused on the association between DNI levels and postoperative mortality.
Main Results:
- Preoperative DNI was significantly associated with mortality (p<0.05), with a 1-unit increase raising death risk 2.61-fold.
- Postoperative DNI was also significantly associated with mortality (p<0.05), with a 1-unit increase raising death risk 10.21-fold.
- Elevated DNI levels are strong independent predictors of mortality.
Conclusions:
- Elevated DNI values are critical for perioperative risk assessment in CABG patients.
- Both preoperative and postoperative DNI levels are significantly linked to mortality, aiding in outcome prediction.
- Integrating DNI into clinical practice can personalize care and improve survival rates for CABG patients.
Background:
Recent interest has focused on the role of inflammatory markers in assessing coronary artery disease (CAD) severity, especially in the early stages. However, there remains a gap in identifying reliable biomarkers to predict postoperative mortality in patients undergoing coronary artery bypass grafting (CABG). Traditional markers such as C-reactive protein (CRP) and white blood cell (WBC) counts are commonly used but have limitations in specificity and prognostic value. The Delta Neutrophil Index (DNI), which reflects immature granulocyte levels, offers a promising alternative. Unlike CRP and WBC, DNI specifically measures the acute inflammatory response, providing a more targeted indicator of risk. This study evaluates the significance of postoperative DNI as a prognostic marker for early mortality in CABG patients, addressing the need for more accurate biomarkers in postoperative care.
Aim:
The aim of this study is to determine the significance of the Delta Neutrophil Index (DNI), which reflects the proportion of immature granulocytes, as a prognostic marker for early postoperative mortality in patients undergoing coronary artery bypass grafting (CABG).
Methods:
This rigorously designed retrospective cohort study was conducted at a high-volume tertiary care center specializing in cardiovascular surgery, including a robust patient cohort to ensure comprehensive data analysis and reliable conclusions. The study included a consecutive series of 446 patients who underwent coronary artery bypass grafting (CABG) between January 1, 2022, and August 1, 2023.
Results:
Mortality was found to be associated with preoperative DNI (p<0.05). A 1-unit increase in pre-DNI measurement was associated with a 2.61-fold (95% Confidence Interval: 1.54-4.45) increase in the risk of death. Additionally, mortality was also associated with postoperative DNI (p<0.05). A 1-unit increase in postoperative DNI measurement was associated with a 10.21-fold (95% Confidence Interval: 5.08-20.05) increase in the risk of death.
Conclusion:
Elevated DNI values are strong independent predictors of postoperative mortality, underscoring its critical role in perioperative risk assessment for CABG patients. Both preoperative and postoperative DNI levels are significantly linked to mortality, emphasizing DNI's value in improving patient outcomes and reducing complications. Integrating DNI into routine clinical practice can provide a more personalized approach to care, enhancing survival and optimizing postoperative management.
