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      The Value of Inflammation Indexes in Predicting Patency of Saphenous Vein Grafts in Patients With Coronary Artery Bypass Graft Surgery

      research-article
      1 , , 2
      ,
      Cureus
      Cureus
      atherosclerosis, thrombosis, inflammation, coronary artery disease, cabg

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          Abstract

          Aim: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).

          Method: 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.

          Results: 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.

          Conclusion: LMR and NLR may be useful predictors for SVGD.

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          Most cited references23

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          Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma.

          We developed a novel systemic immune-inflammation index (SII) based on lymphocyte, neutrophil, and platelet counts and explored its prognostic value in hepatocellular carcinoma (HCC).
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            Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study.

            This study defined long-term patency of saphenous vein grafts (SVG) and internal mammary artery (IMA) grafts. This VA Cooperative Studies Trial defined 10-year SVG patency in 1,074 patients and left IMA patency in 457 patients undergoing coronary artery bypass grafting (CABG). Patients underwent cardiac catheterizations at 1 week and 1, 3, 6, and 10 years after CABG. Patency at 10 years was 61% for SVGs compared with 85% for IMA grafts (p 2.0 mm in diameter SVG patency was 88% versus 55% in vessels 2.0 mm in diameter.
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              Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting.

              An elevated preoperative white blood cell count has been associated with a worse outcome after coronary artery bypass grafting (CABG). Leukocyte subtypes, and particularly the neutrophil-lymphocyte (N/L) ratio, may however, convey superior prognostic information. We hypothesized that the N/L ratio would predict the outcome of patients undergoing surgical revascularization. Baseline clinical details were obtained prospectively in 1938 patients undergoing CABG. The differential leukocyte was measured before surgery, and patients were followed-up 3.6 years later. The primary end point was all-cause mortality. The preoperative N/L ratio was a powerful univariable predictor of mortality (hazard ratio [HR] 1.13 per unit, P 3.36). An elevated N/L ratio is associated with a poorer survival after CABG. This prognostic utility is independent of other recognized risk factors.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                26 July 2021
                July 2021
                : 13
                : 7
                : e16646
                Affiliations
                [1 ] Cardiology, Namık Kemal University Faculty of Medicine Tekirdağ, Tekirdağ, TUR
                [2 ] Cardiovasculer Surgery, Bursa Yuksek Ihtisas Research and Education Hospital, Bursa, TUR
                Author notes
                Article
                10.7759/cureus.16646
                8387011
                34462681
                a77057b0-602d-49ab-83c5-c1bf6da93de9
                Copyright © 2021, Aydın et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 July 2021
                Categories
                Cardiac/Thoracic/Vascular Surgery
                Cardiology
                Endocrinology/Diabetes/Metabolism

                atherosclerosis,thrombosis,inflammation,coronary artery disease,cabg

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