Sistemik İmmün-İnflamasyon İndeksi, Düşük Ejeksiyon Fraksiyonuna Sahip Koroner Arter Baypas Greftleme Uygulanan Hastalarda Postoperatif Atriyal Fibrilasyon Riskini Öngörebilir mi?

Year 2025, Volume: 35 Issue: 1, 150 - 154, 28.02.2025

Mehmet Emir Erol , İsa Civelek

https://doi.org/10.54005/geneltip.1578821

Abstract

Amaç: Bu çalışmanın amacı, düşük ejeksiyon fraksiyonu (EF) ile koroner arter baypas greftleme (CABG) uygulanan hastalarda, preoperatif dönemde belirlenen Sistemik İmmün-İnflamasyon İndeksi’nin (SII), postoperatif atriyal fibrilasyon (PoAF) gelişimini öngörmedeki potansiyel rolünü araştırmaktır.

Gereç ve Yöntemler: Ocak 2023 ile Ocak 2024 tarihleri arasında düşük EF (%40’ın altında) ile CABG uygulanan toplam 100 hasta çalışmaya dahil edilmiştir. Çalışmada, hastaların preoperatif SII değerleri ile demografik özellikleri ve operasyonel değişkenleri karşılaştırılmıştır.

Bulgular: Düşük ejeksiyon fraksiyonuna sahip 100 hasta arasında, postoperatif atriyal fibrilasyon on olguda tespit edilmiştir. Demografik ve perioperatif değişkenlerde anlamlı bir farklılık saptanmamıştır. Bununla birlikte, PoAF gelişen on hastada SII seviyelerinin anlamlı derecede yüksek olduğu ve bu durumun bir korelasyon gösterdiği belirlenmiştir (p=0,008). PoAF gelişen hastaların hastanede kalış süresi, istatistiksel olarak anlamlı olmamakla birlikte, daha uzun bulunmuştur (p=0,059).

Sonuç: Preoperatif SII seviyelerinin, düşük ejeksiyon fraksiyonuna sahip koroner arter baypas greftleme uygulanan hastalarda postoperatif atriyal fibrilasyon gelişimini öngörmede potansiyel bir belirteç olarak işlev görebileceği düşünülmektedir.

Keywords

Koroner Arter Baypas, Atriyal Fibrilasyon, Kardiyopulmoner Baypas, İnflamasyon

Can the Systemic Immune-Inflammation Index Predict the Risk of Postoperative Atrial Fibrillation in Patients with Low Ejection Fraction Undergoing Coronary Artery Bypass Grafting?

Abstract

Objective: This study aimed to investigate whether the preoperative Systemic Immune-Inflammation Index (SII) can predict the development of postoperative atrial fibrillation (PoAF) in patients undergoing coronary artery bypass grafting (CABG) with low ejection fraction (EF).

Materials and Methods: Between January 2023 and January 2024, 100 patients who underwent CABG with low EF(40%) were included in the study. Preoperative SII values of the patients, along with their demographic characteristics and operative variables, were compared.

Results: Among the 100 patients with reduced ejection fraction included in the study, postoperative atrial fibrillation was identified in 10 cases. No significant differences were observed in the demographic and perioperative data of the patients. The SII levels were found to be higher in ten patients who developed PoAF, demonstrating a correlation (p=0.008). PoAF patients experienced a longer stay in the hospital although statistically insignificant (p=0.059).

Conclusion: Preoperative SII levels may be effective in predicting postoperative atrial fibrillation in coronary bypass patients with low ejection fraction.

Keywords

Coronary Artery Bypass, Atrial Fibrillation, Cardiopulmonary Bypass, Inflammation

References

• 1. Woldendorp K, Farag J, Khadra S, Black D, Robinson B, Bannon P. Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta-Analysis. Ann Thorac Surg [Internet]. 2021 Dec 1 [cited 2024 Nov 3];112(6):2084–93. Available from: https://pubmed.ncbi.nlm.nih.gov/33340521/
• 2. Wang MK, Meyre PB, Heo R, Devereaux PJ, Birchenough L, Whitlock R, et al. Short-term and Long-term Risk of Stroke in Patients With Perioperative Atrial Fibrillation After Cardiac Surgery: Systematic Review and Meta-analysis. CJC Open [Internet]. 2021 Jan 1 [cited 2024 Nov 3];4(1):85–96. Available from: https://pubmed.ncbi.nlm.nih.gov/35072031/
• 3. Shen J, Lall S, Zheng V, Buckley P, Damiano RJ, Schuessler RB. The persistent problem of new-onset postoperative atrial fibrillation: a single-institution experience over two decades. J Thorac Cardiovasc Surg [Internet]. 2011 Feb [cited 2024 Nov 3];141(2):559–70. Available from: https://pubmed.ncbi.nlm.nih.gov/20434173/
• 4. Gillinov AM, Bagiella E, Moskowitz AJ, Raiten JM, Groh MA, Bowdish ME, et al. Rate Control versus Rhythm Control for Atrial Fibrillation after Cardiac Surgery. N Engl J Med [Internet]. 2016 May 19 [cited 2024 Nov 3];374(20):1911–21. Available from: https://pubmed.ncbi.nlm.nih.gov/27043047/
• 5. Taha A, Nielsen SJ, Franzén S, Rezk M, Ahlsson A, Friberg L, et al. Stroke Risk Stratification in Patients With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting. J Am Heart Assoc [Internet]. 2022 May 17 [cited 2024 Nov 3];11(10). Available from: https://pubmed.ncbi.nlm.nih.gov/35574947/
• 6. Mariscalco G, Klersy C, Zanobini M, Banach M, Ferrarese S, Borsani P, et al. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation [Internet]. 2008 Nov 14 [cited 2024 Nov 3];118(16):1612–8. Available from: https://pubmed.ncbi.nlm.nih.gov/18824644/
• 7. Smukowska-Gorynia A, Perek B, Jemielity M, Olasińska-Wiśniewska A, Marcinkowska J, Stefaniak S, et al. Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting. Kardiol Pol [Internet]. 2022 [cited 2024 Nov 3];80(9):902–10. Available from: https://pubmed.ncbi.nlm.nih.gov/35698968/
• 8. Dey S, Kashav R, Kohli JK, Magoon R, ItiShri, Walian A, et al. Systemic Immune-Inflammation Index Predicts Poor Outcome After Elective Off-Pump CABG: A Retrospective, Single-Center Study. J Cardiothorac Vasc Anesth [Internet]. 2021 Aug 1 [cited 2024 Nov 3];35(8):2397–404. Available from: https://pubmed.ncbi.nlm.nih.gov/33046365/
• 9. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. The systemic immune-inflammation index predicts the prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res [Internet]. 2014 Dec 1 [cited 2024 Nov 3];20(23):6212–22. Available from: https://pubmed.ncbi.nlm.nih.gov/25271081/
• 10. Qureshi M, Ahmed A, Massie V, Marshall E, Harky A. Determinants of atrial fibrillation after cardiac surgery. Rev Cardiovasc Med [Internet]. 2021 Jun 30 [cited 2024 Nov 3];22(2):329–41. Available from: https://pubmed.ncbi.nlm.nih.gov/34258901/
• 11. Gudbjartsson T, Helgadottir S, Sigurdsson MI, Taha A, Jeppsson A, Christensen TD, et al. New-onset postoperative atrial fibrillation after heart surgery. Acta Anaesthesiol Scand [Internet]. 2020 Feb 1 [cited 2024 Nov 3];64(2):145–55. Available from: https://pubmed.ncbi.nlm.nih.gov/31724159/
• 12. Maesen B, Nijs J, Maessen J, Allessie M, Schotten U. Post-operative atrial fibrillation: a maze of mechanisms. Europace [Internet]. 2012 Feb [cited 2024 Nov 3];14(2):159–74. Available from: https://pubmed.ncbi.nlm.nih.gov/21821851/
• 13. Jagadish PS, Kirolos I, Khare S, Rawal A, Lin V, Khouzam RN. Post-operative atrial fibrillation: should we anticoagulate? Ann Transl Med [Internet]. 2019 Sep [cited 2024 Nov 3];7(17):407–407. Available from: https://pubmed.ncbi.nlm.nih.gov/31660306/
• 14. Uysal D, Aksoy F, Ibrişim E. The Validation of the ATRIA and CHA2DS2-Vasc Scores in Predicting Atrial Fibrillation after Coronary Artery Bypass Surgery. Braz J Cardiovasc Surg [Internet]. 2020 [cited 2024 Nov 3];35(5):619–25. Available from: https://pubmed.ncbi.nlm.nih.gov/33118725/
• 15. Magoon R. Evolving Spectrum of Prognostic Inflammatory Markers in Infective Endocarditis. J Cardiothorac Vasc Anesth [Internet]. 2020 Jul 1 [cited 2024 Nov 3];34(7):2001–2. Available from: https://pubmed.ncbi.nlm.nih.gov/32147322/
• 16. Weymann A, Popov AF, Sabashnikov A, Ali-Hasan-Al-Saegh S, Ryazanov M, Tse G, et al. Baseline and postoperative levels of C-reactive protein and interleukins as inflammatory predictors of atrial fibrillation following cardiac surgery: a systematic review and meta-analysis. Kardiol Pol [Internet]. 2018 Feb 16 [cited 2024 Nov 3];76(2):440–51. Available from: https://pubmed.ncbi.nlm.nih.gov/29354906/
• 17. Liakopoulos OJ, Kuhn EW, Slottosch I, Wassmer G, Wahlers T. Preoperative statin therapy for patients undergoing cardiac surgery. Cochrane Database Syst Rev [Internet]. 2012 Apr 18 [cited 2024 Nov 3];2012(4). Available from: https://pubmed.ncbi.nlm.nih.gov/22513959/
• 18. Chello M, Anselmi A, Spadaccio C, Patti G, Goffredo C, Di Sciascio G, et al. Simvastatin increases neutrophil apoptosis and reduces inflammatory reactions after coronary surgery. Ann Thorac Surg [Internet]. 2007 Apr [cited 2024 Nov 3];83(4):1374–80. Available from: https://pubmed.ncbi.nlm.nih.gov/17383342/