Low-grade inflammation in the prognosis of patients undergoing coronary artery bypass grafting: the value of neutrophil-to-lymphocyte ratio (NLR) and growth differentiation factor 15 (GDF15)

Abstract

Background Predicting major adverse cardiovascular events (MACEs) after coronary interventions is an urgent and important task. Subclinical inflammation markers are becoming increasingly investigated for this purpose. Aim To determine the role of the neutrophil-to-lymphocyte ratio (NLR) and growth differentiation factor 15 (GDF-15) in predicting MACE in patients after coronary artery bypass grafting (CABG). Methods This prospective observational study included 80 patients with coronary artery disease who underwent CABG and were followed up for at least 1 year. In a prospective follow-up, a combined endpoint (MACE) had 27.5% (a total of 22 events). Results The values of GDF-15 and NLR were comparable in groups with and without MACE. A ROC analysis showed a low AUC for NLR (AUC = 0.566 (p = 0.363)) and GDF-15 (AUC = 0.621 (p = 0.096)). The value of the product GDF-15*NLR was determined. The median was 3108.05 (2069; 4145) for patients who did not have MACE and 4108.8 (2779.4; 5890.5) for patients with MACE (p = 0.010). This association remained after the introduction of amendments to sex, age, diabetes, and left ventricular ejection fraction. Conclusions The value of the product indicators NLR and GDF-15 is associated with the development of adverse cardiovascular events in patients after CABG.