Abstract
Our study aimed to investigate the predictive values of inflammation markers in predicting postoperative saphenous vein graft patency in patients who underwent coronary artery bypass grafting (CABG). We retrospectively analyzed 89 patients who undergone CABG, and 49 patients diagnosed with non-critical coronary artery disease (less than ≤50% stenosis) on coronary angiography were included in the study as a control group. Eighty-nine patients who underwent CABG were divided into two groups according to the presence of 50% or more stenosis in saphenous vein grafts. In these three groups of patients, neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR; neutrophils/white blood cells-neutrophils), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic inflammation response index (SIRI; neutrophils × monocytes/lymphocytes), systemic inflammation index (SII; platelet × neutrophil/lymphocyte), and the aggregate index of systemic inflammation (AISI; neutrophil × platelet × monocyte/lymphocyte ratio)were calculated from blood tests. The primary endpoint was more than 50% of saphenous vein stenosis or occlusion, and the aim is to predict this saphenous vein graft disease by inflammation indexes. The groups were similar in terms of the frequency of stroke, diabetes mellitus, and chronic obstructive pulmonary disease. The frequency of heart failure and hypertension was higher in group 2 (p=0.045, p=0.005), respectively. Multivariate logistic regression analysis showed that LMR and NLR levels were independent predictors of saphenous vein graft disease (SVGD; OR: 0.896; 95%CI: 0.465-0.957; P<0.001) , (OR: 0.592; 95%CI: 0.450-0.875; P=0.034, respectively).The cut-off value of the LMR <2.625 was associated with 78.4% sensitivity and 78% specificity to predict saphenous vein graft disease in patients with CABG. LMR and NLR may be useful predictors for SVGD.
Highlights
Endovascular stent technology has advanced day by day, coronary artery bypass grafting (CABG) is still the most effective treatment method in some patient groups
Multivariate logistic regression analysis showed that lymphocyte to monocyte ratio (LMR) and neutrophil to lymphocyte ratio (NLR) levels were independent predictors of saphenous vein graft disease (SVGD; OR: 0.896; 95%CI: 0.465-0.957; P
An increase in inflammation risk markers such as neutrophil to lymphocyte ratio (NLR) or platelet to lymphocyte ratio (PLR) after CABG or percutaneous coronary intervention has been found useful in predicting cardiovascular mortality or in-stent restenosis [5]
Summary
Endovascular stent technology has advanced day by day, coronary artery bypass grafting (CABG) is still the most effective treatment method in some patient groups. Faster progression of atherothrombotic occlusive disease causes lower long-term patency rates. It has been found in many studies that arterial graft selection increases long-term survival and decreases the frequency of coronary angiographic interventions [1,2]. While the cause of occlusion in vein grafts in the early period (first month) after bypass surgery is thrombotic occlusion, in the late period the reasons are atherosclerosis and neointimal hyperplasia. As it is known, a low grade of continuous inflammation plays a role in the pathogenesis of atherosclerosis. An increase in inflammation risk markers such as neutrophil to lymphocyte ratio (NLR) or platelet to lymphocyte ratio (PLR) after CABG or percutaneous coronary intervention has been found useful in predicting cardiovascular mortality or in-stent restenosis [5]
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