Predictive Value of Neutrophil-Lymphocyte Ratio for Long-Term Cardiovascular Event Following Coronary Artery Bypass Grafting

Gürbüz, Orçun; Kumtepe, Gencehan; Özkan, Hakan; Karal, Ilker Hasan; Velioğlu, Yusuf; Ercan, Abdulkadir; Yüksel, Ahmet; Ener, Serdar

doi:10.21470/1678-9741-2018-0362

Cited by 29 publications

(26 citation statements)

References 25 publications

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“…Baseline and clinical characteristics of the study population Recent literature of Gurbuz et al reported the 7.8-year follow-up results. In this 751-CABG-patient study, the elevated NLR with the cut-off value of 4.32 was associated with long-term adverse cardiac events(19).…”

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confidence: 68%

The neutrophil-lymphocyte ratio is associated with postoperative mortality of cardiac surgery

Wang¹,

Li²,

Wang³

2021

J Thorac Dis

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Background: The neutrophil-lymphocyte ratio (NLR) has been recognized as a useful marker of poor prognosis in non-cardiac surgery patients. But, the prognostic function of NLR in cardiovascular surgery patients still largely unknown. The aim of this study was to explore the relationship between postoperative NLR and mortality in cardiac surgery patients.Methods: Clinical data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Postoperative day 1 (POD-1) NLR of the patients was calculated. All patients were divided into two groups according to the cut-off value of NLR, which was determined using the receiver operating characteristic (ROC) curve and Youden Index. The primary death outcomes were 30-day, 90-day and 1-year mortality. Cox proportional hazard analysis was performed to assess the associations between NLR and 1-year mortality. Logistic analysis was performed to assess the associations between NLR and other outcomes.Multivariate analyses were used to control for confounders.Results: A total of 2,707 cardiac surgery patients were included in this study. The cut-off value of postoperative NLR was 7.28. Elevated postoperative NLR was associated with increased death outcomes including 30-day mortality [adjusted odds ratio (OR) 2.25, P=0.019], 90-day mortality (adjusted OR 2.49, P=0.001) and 1-year mortality [adjusted hazard ratio (HR) 1.58, P=0.03] of cardiac surgery in cox proportional hazard model. Elevated NLR was also associated with increased risk of continuous renal replacement therapy (CRRT) rate (adjusted OR 3.01, P=0.004), prolonged ICU stays (adjusted OR 2.55, P<0.001), prolonged hospital stays (adjusted OR 3.32, P<0.001) and duration of ventilatory support (adjusted OR 4.16, P<0.001) after adjusting confounders.Conclusions: Elevated postoperative NLR was significantly associated with increased short-term and long-term mortality, CRRT rate, longer ICU and hospital stay, prolonged ventilation in patients undergoing cardiac surgery. NLR is promising to be a readily available and independent prognostic biomarker for patients with cardiac surgery.

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confidence: 68%

The neutrophil-lymphocyte ratio is associated with postoperative mortality of cardiac surgery

Wang¹,

Li²,

Wang³

2021

J Thorac Dis

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“…The postoperative NLR results were related to ICU stay and length of hospitalization in previous studies [ 10 ]. The correlation between the risk of MACCE following surgical revascularization in CPB was presented with a cut-off value of 4.32 in the multivariable analysis [ 11 ]. We present the results of the study with a similar cut-off value for mid-term mortality as the end-point analysis.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Neutrophil to Lymphocyte Ratio as an Overall Mortality Midterm Prognostic Factor following OPCAB Procedures

Urbanowicz

Michalak

Perek

et al. 2021

Clinics and Practice

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Background: Off-pump coronary artery bypass grafting (OPCAB) is believed to limit inflammatory reaction. Neutrophil to lymphocyte ratio (NLR) is one of the more common and easily accessible markers of inflammatory response. The aim of the study was to compare postoperative results of NLR with mid-term OPCAB results. Methods: In total, 224 patients (198 (88%) men and 26 (12%) women) with mean age 65 +/− 9 years who underwent OPCAB though median full sternotomy in our department in 2018 enrolled into the study. We scrupulously collected the postoperative mid-term results, including survival rate, clinical status and risk for major adverse events, and compared them with perioperative laboratory results. Results: A three-year follow-up was completed by 198 individuals (90% survival rate) with 12 (5%) showing major adverse cardiovascular (MACE) events risk. In the multivariable analysis, the laboratory parameters noticed on the 1st postoperative day were statistically significantly predictive of survival, including neutrophils (HR 1.59, 1.33–1.89 95%CI, p < 0.0001), platelets (HR 1.01, 1.01–1.01 95%CI, p = 0.0065), NLR (HR 1.47, 1.3–1.65 95%CI, p < 0.0001) and postoperative ejection fraction (HR 0.9, 0.87–0.95 95%CI, p < 0.0001). Conclusions: Postoperative NLR above 4.6, as an inflammatory reaction marker, is related to mid-term mortality in OPCAB patients.

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“…Therefore, the NLR increases with the increase in the neutrophil ratio and decrease in the lymphocyte count, which has prognostic significance in various diseases. [ 12 ] There are basically two reasons why the prognostic value of NLR is important. The first is that this value is less affected by possible physiological conditions, such as dehydration and exercise, compared to other inflammatory parameters.…”

Section: Discussionmentioning

confidence: 99%

The effect of the relationship between post-cardiotomy neutrophil/lymphocyte ratio and platelet counts on early major adverse events after isolated coronary artery bypass grafting

Abanoz

Engin

2021

Turk Gogus Kalp Dama

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Background In this study, we aimed to investigate the role of postcardiotomy neutrophil, lymphocyte, and platelet counts in predicting major adverse events after coronary artery bypass grafting. Methods A total of 373 patients (257 males, 116 females; median age 63, range 33 to 85 years) who underwent isolated coronary artery bypass grafting under cardiopulmonary bypass between January 2015 and January 2020 were retrospectively analyzed. The patients who did not develop any postoperative major adverse event were included in Group 1, while those who did constituted Group 2. Preoperative neutrophil-to-lymphocyte ratio, postcardiotomy neutrophil-to-lymphocyte ratio, postoperative Day 1 neutrophil-to-lymphocyte ratio, and neutrophil-to-lymphocyte x platelet ratio were calculated. Results Preoperative neutrophil counts, C-reactive protein values, neutrophilto- lymphocyte ratio, total perfusion time, and length of intensive care unit and hospital stay were significantly higher in Group 2 (p=0.019, p=0.028, p<0.001, p=0.027, p<0.001, and p<0.001, respectively). Post-cardiotomy neutrophil, neutrophil-to-lymphocyte ratio, and neutrophil-to-lymphocyte x platelet ratio, along with the postoperative first day white blood cell count, neutrophil, C-reactive protein, neutrophil-to-lymphocyte ratio, and neutrophil-to-lymphocyte x platelet ratio were significantly higher in Group 2 (p=0.004, p<0.001, p<0.001, p=0.019, p=0.003, p=0.001, p<0.001, and p=0.041, respectively). The post-cardiotomy platelet and lymphocyte counts and postoperative first day lymphocyte counts were significantly lower in Group 2 (p<0.001, p=0.007, and p=0.009, respectively). Conclusion Post-cardiotomy neutrophil-to-lymphocyte ratio and neutrophilto- lymphocyte x platelet ratio can be easily accessible, inexpensive complete blood count parameters and may be more valuable in predicting major adverse events in patients undergoing coronary artery bypass grafting.

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Predictive Value of Neutrophil-Lymphocyte Ratio for Long-Term Cardiovascular Event Following Coronary Artery Bypass Grafting

Cited by 29 publications

References 25 publications

The neutrophil-lymphocyte ratio is associated with postoperative mortality of cardiac surgery

The neutrophil-lymphocyte ratio is associated with postoperative mortality of cardiac surgery

Postoperative Neutrophil to Lymphocyte Ratio as an Overall Mortality Midterm Prognostic Factor following OPCAB Procedures

The effect of the relationship between post-cardiotomy neutrophil/lymphocyte ratio and platelet counts on early major adverse events after isolated coronary artery bypass grafting

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