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

PLoS One. 2022 Dec 15;17(12):e0276138. doi: 10.1371/journal.pone.0276138. eCollection 2022.

Abstract

Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59-64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17-17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001).

MeSH terms

  • Coronary Artery Bypass / methods
  • Coronary Artery Bypass, Off-Pump* / methods
  • Coronary Artery Disease* / surgery
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Systemic Inflammatory Response Syndrome / etiology
  • Treatment Outcome

Grants and funding

The authors received no specific funding for this work.