The Role of «Novel» Biomarkers of Systemic Inflammation in the Development of Early Hospital Events after Aortic Valve Replacement in Patients with Aortic Stenosis

Abstract

Introduction. The pathogenesis of aortic stenosis includes the processes of chronic inflammation, calcification, lipid metabolism disorders, and congenital structural changes. The goal of our study was to determine the predictive value of novel biomarkers of systemic inflammation and some hematological indices based on the numbers of leukocytes and their subtypes in the development of early hospital medical conditions after mechanical aortic valve replacement in patients with aortic stenosis. Materials and methods. This was a cohort study involving 363 patients who underwent surgical intervention for aortic valve pathology between 2014 and 2020. The following markers of systemic inflammation and hematological indices were studied: SIRI (Systemic Inflammation Response Index), SII (Systemic Inflammation Index), AISI (Aggregate Index of Systemic Inflammation), NLR (Neutrophil/Lymphocyte Ratio), PLR (Platelet/Lymphocyte Ratio), and MLR (Monocyte/Lymphocyte Ratio). Associations of the levels of these biomarkers and indices with the development of in-hospital death, acute kidney injury, postoperative atrial fibrillation, stroke/acute cerebrovascular accident, and bleeding were calculated. Results. According to an ROC analysis, an SIRI > 1.5 (p < 0.001), an SII > 718 (p = 0.002), an AISI > 593 (p < 0.001), an NLR > 2.48 (p < 0.001), a PLR > 132 (p = 0.004), and an MLR > 0.332 (p < 0.001) were statistically significantly associated with in-hospital death. Additionally, an SIRI > 1.5 (p < 0.001), an NLR > 2.8 (p < 0.001), and an MLR > 0.392 (p < 0.001) were associated with bleeding in the postoperative period. In a univariate logistic regression, SIRI, SII, AISI, and NLR were statistically significant independent factors associated with in-hospital death. In a multivariate logistic regression model, SIRI was the most powerful marker of systemic inflammation. Conclusion. SIRI, SII, AISI, and NLR as novel biomarkers of systemic inflammation were associated with in-hospital mortality. Of all markers and indices of systemic inflammation in our study, SIRI was the strongest predictor of a poor outcome in the multivariate regression model.

Inflammation Indexes PLR, SII, AISI, MLR, and MCVL in Peripartum Treated Thrombophilia Peripartum Patients Undergoing Cesarean Section at Term

“…In with hemophagocytic lymphohistiocytosis, the aggregate index of systemic inflammation (AISI) was also an independent risk factor for 28-day mortality [37]. After aortic valve replacement, AISI was a statistically significant independent factor associated with inhospital death [38]. This also proved our working hypothesis: there is an underlying inflammatory state, and it persisted despite treatment in some patients.…”

Inflammation Indexes PLR, SII, AISI, MLR, NLPR and MCVL in Peripartum Treated Thrombophilia Patients Undergoing Cesarean Section at Term-STROBE Compliant

“…In patients with hemophagocytic lymphohistiocytosis, the aggregate index of systemic inflammation (AISI) was also an independent risk factor for 28-day mortality [49]. After aortic valve replacement, AISI was a statistically significant independent factor associated with inhospital death [50]. This also proved our working hypothesis: there is an underlying inflammatory state, and it persisted despite treatment in some patients.…”