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Urbanowicz T, Michalak M, Al-Imam A, Olasińska-Wiśniewska A, Rodzki M, Witkowska A, Haneya A, Buczkowski P, Perek B, Jemielity M. The Significance of Systemic Immune-Inflammatory Index for Mortality Prediction in Diabetic Patients Treated with Off-Pump Coronary Artery Bypass Surgery. Diagnostics (Basel) 2022; 12:diagnostics12030634. [PMID: 35328187 PMCID: PMC8947274 DOI: 10.3390/diagnostics12030634] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/14/2022] [Accepted: 02/25/2022] [Indexed: 02/08/2023] Open
Abstract
Diabetes mellitus (DM) represents a complex carbohydrate metabolism disorder characterized by inflammatory over-reactivity. The study aimed to investigate the potential influence of postoperative inflammatory activation on mortality risk after off-pump coronary artery bypass grafting in diabetic patients. There were 510 patients treated with off-pump coronary artery bypass grafting due to stable complex coronary artery disease, including 175 patients with type-2 DM (T2DM.) The mean follow-up time was 3.7 +/− 1.5 years with a 9% all-cause mortality rate in the diabetic group. In multivariable analysis, preoperative comorbidities (stroke, peripheral artery disease, postoperative systemic inflammatory index >952, and postoperative left ventricle ejection fraction (LVEF) < 45%) were revealed as prognostic factors. The receiver operator characteristics curve analysis for postoperative calculations of systemic immune-inflammatory index (SII) appeared significant (AUC = 0.698, p = 0.008), yielding sensitivity of 68.75% and specificity of 71.07%. Systemic immune-inflammatory index (SII) can be regarded as a predictive marker for long-term prognosis in diabetic patients after off-pump coronary artery bypass grafting. The role of perioperative inflammatory activation may play a crucial role in mortality prediction.
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Affiliation(s)
- Tomasz Urbanowicz
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
- Correspondence: ; Tel.: +48-61-854-9210
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 61-806 Poznan, Poland; (M.M.); (A.A.-I.)
| | - Ahmed Al-Imam
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 61-806 Poznan, Poland; (M.M.); (A.A.-I.)
- Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
| | - Anna Olasińska-Wiśniewska
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
| | - Michał Rodzki
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
| | - Anna Witkowska
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
| | - Assad Haneya
- Herz and Gefaschirurgie, Universitatklinikum Schleswig-Holstein, 24105 Kiel, Germany;
| | - Piotr Buczkowski
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
| | - Bartłomiej Perek
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
| | - Marek Jemielity
- Cardiac Surgery and Transplantalogy Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (A.O.-W.); (M.R.); (A.W.); (P.B.); (B.P.); (M.J.)
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