New hematologic markers of immuno-inflammation and Severe perioperative complications after cardiac surgery.
DOI:
https://doi.org/10.56294/hl2023267Keywords:
Hematological markers, immuno-inflammation, cardiovascular surgeryAbstract
Introduction: The high morbidity and mortality of cardiovascular surgical patients and their high costs lead to the search for markers that can predict adverse effects and post-surgical complications in time and facilitate a better evaluation of these patients. Objective: to evaluate the degree of association of selected hematological markers of immuno-inflammation with the appearance of serious perioperative complications Methods: An ambispective cohort study was carried out on patients who underwent major cardiovascular surgery between January 1, 2019 and December 31, 2023 at the Cardiocentro of Santiago de Cuba, who met inclusion criteria. Results: A close link was demonstrated between the appearance of serious perioperative complications with the evaluated markers: Neutrophil/lymphocyte ratio (p=0.000 RR 26.90), Platelet/lymphocyte ratio (p=0.000 RR 11.07), Systemic immuno-inflammatory index (p=0.000 RR 2.66). Conclusions: The appearance of complications was high but in accordance with what was found in the international and national literature, a close link was evidenced between the new hematological markers and complications, which could allow earlier monitoring, diagnosis and treatment of complications and reduce morbidity and mortality in these patients.
References
Libby P, Bonow RO, Mann DL, Tomaselli GO, Bhatt DL, Solomon SD, Braunwald E(ed). Braunwald `s Heart Disease. A textbook of cardiovascular Medicine. 12 edic, Elsevier Saunders, Philadelphia 2022, p 3, 410-23
Imperiali Rosario C. Evaluación de la fracción de plaquetas inmaduras y de otros biomarcadores asociados a complicaciones inflamatorias en el postoperatorio de cirugía cardíaca. Tesis doctoral. Universidad autónoma de Barcelona. Barcelona. España. 2020
Huan Luo. Risk-Predictive Models for Adverse Events in Cardiac Surgery: A Review. Cardiovascular Innovations and Applications. Vol. 9 (2024) 3 DOI 10.15212/CVIA.2023.0083
Zalaquett R. (2017a). 50 años de cirugía bypass coronario. Meditar el pasado, enfrentar el presente y forjar el futuro. Revista Chilena de Cardiología 36,162-169.
Zalaquett R. (2022a). Desarrollo histórico de la cirugía cardiovascular. Revista Médica de la Clínica las Condes 33, 192-200.
Zalaquett R. (2022b) Desarrollo histórico de la protección miocárdica: El gran salto delante de la cirugía cardiovascular Revista Chilena de Cardiología 41, 206-215.
Zalaquett R. (2023). 70 años del invento que cambió el tratamiento de las enfermedades cardiovasculares: “La máquina corazón-pulmón”. Revista Chilena de Cardiología 42, 80-81.
Nearman H, Klick JC, Eisenberg P, Pesa N. Perioperative complications of cardiac surgery and postoperative care. Crit Care Clin. 2014;30(3):527-55.
Wang W, Bagshaw SM, Norris CM, Zibdawi R, Zibdawi M, MacArthur R, et al. Association between older age and outcome after cardiac surgery: a population-based cohort study. J Cardiothorac Surg. 2014; 9:177
Laffey JG, Boylan JF, Cheng DC. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anesthesiology. 2002;97(1):215-52.
Millar JE, Fanning JP, McDonald CI, McAuley DF, Fraser JF. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology. Crit Care. 2016;20(1):387
Hatami S, Hefler J and Freed DH (2022) Inflammation and Oxidative Stress in the Context of Extracorporeal Cardiac and Pulmonary Support. Front. Immunol 2022 13: 831930.doi: 10.3389/fimmu.2022.831930
Omran, F.; Kyrou, I.;Osman, F.; Lim, V.G.; Randeva, H.S.;Chatha, K. Cardiovascular Biomarkers: Lessons of the Past and Prospects for the Future. Int. J. Mol. Sci. 2022, 23, 5680. https:// doi.org/10.3390/ijms23105680
Rodríguez-Morales M, Díaz-Quiroz G, Aceves-Chimal JL, Flores Calderón O, García-Ortegón MS, Andrés Jaime-Uribe A. et al. Regulatory T cells in the "inflammatory balance" as a response to extracorporeal circulation in cardiac surgery. A narrative review. Cir Card Mex 2024; 9(1): 10-29.
Mocumbi AO. Cardiovascular Health Care in Low- and Middle-Income Countries. Circulation. 2024; 149:557–559. DOI: 10.1161/circulationaha.123.065717
Gómez Guirola L, Núñez Fernández R, Paredes Cordero A. Valor pronóstico de variables preoperatorias y del EUROSCORE II en cirugía valvular y aorta ascendente. Ponencia
Felizola Rodríguez A, Martí Pérez JC; Ginarte Rodríguez G;Berdión Sevilla J; Luque Borjas E et al. Complicaciones mayores en el período posoperatorio inmediato de la cirugía cardiaca abierta. MEDISAN 2005;9 (1).
Rincón Salas JJ, Novoa Lago E, Sánchez E, Hortal Iglesias J. Manejo de las complicaciones postoperatorias de la cirugía cardiaca en cuidados intensivo. Rev Asoc Mex Med Crit y Ter Int 2013;27(3):172-178.
Jiménez Rivera JJ, Llanos Joge C, López Gude ME, Pérez Vela JL. En representación del GTCICYRCP. Manejo perioperatorio en cirugía cardiovascular. Medicina Intensiva 2021;45(3): 175-183
Gu L, Xia Z, Qing B, Chen H, Wang W, Chen Y and Yuan Y (2022) The Core Role of Neutrophil–Lymphocyte Ratio to Predict All-Cause and Cardiovascular Mortality: A Research of the 2005–2014 National Health and Nutrition Examination Survey. Front Cardiovasc Med. 9:847998. doi: 10.3389/fcvm.2022.847998
Sebastian Roth, René M’Pembele, Alexandra Stroda, Catrin Jansen, Giovanna Lurati Buse, Udo Boeken et al. Neutrophil‑lymphoycyte‑ratio, platelet‑lymphocyte‑ratio and procalcitonin for early assessment of prognosis in patients undergoing VA‑ECMO. Scientifc Reports | (2022) 12:542 https://doi.org/10.1038/s41598-021-04519-7 www.nature.com/scientificreports
Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. Hindawi Disease Markers Volume 2017, Article ID 3041565, 9 pages https://doi.org/10.1155/2017/3041565
Simon J, Guptha S, Rajalakshmi K, et al. (May 28, 2024) Evaluating Cardiovascular Risks: The Platelet Lymphocyte Ratio and the Neutrophil Lymphocyte Ratio As High-Risk Heart Score Predictors in Non-ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina Patients. Cureus1 6(5): e61 279. DOI 1 0.7759/cureus.61 279
Urbanowicz, T.; Olasi´nskaWi´sniewska, A.; Michalak, M.; Rodzki, M.; Witkowska, A.; Straburzy´nska-Migaj, E.; Perek, B.; Jemielity, M. The Prognostic Significance of Neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR)on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) Procedures. Biology 2022, 11, 34. https://doi.org/10.3390/ biology11010034
Rodríguez Blanco S, Cruz Cardentey M, Leyva Quert AY , Aguilar Medina JM , Gutiérrez López A, Pérez Yánes M. Índice neutrófilo-linfocitario en la predicción de eventos adversos del intervencionismo coronario percutáneo. Revista Argentina de Cardioangiología Intervencionista 2021;12(2):82-87. https://doi.org/10.30567/RACI/202102/0082-0087
Lakobishvili Z, Beigel R, Shlomo N, Matetzky S, Zahger D, Atar S M. The predictive value of low admission hemoglobin over the GRACE score in patients with acute coronary syndrome. Journal of Cardiology 2019; 73(4): 271-275. https://www.sciencedirect.com/science/j/09145087
Hu B, Yang XR, Xu Y, Sun YF, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20:6212-6222. 8.
de Mendonca-Filho HT, Pereira KC, Fontes M, Vieira DA, de Mendonca ML, Campos LA, et al. Circulating inflammatory mediators and organ dysfunction after cardiovascular surgery with cardiopulmonary bypass: a prospective observational study. Crit Care. 2006;10(2):R46.
Azab, B.; Shah, N.; Akerman, M.; McGinn, J.T., Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J. Thromb Thrombolysis. 2012, 34, 326–334.
Saskın, H.; Düzyol, Ç.; Özcan, K.S.; Aksoy, R.; Idiz, M. Preoperative Platelet to Lymphocyte Ratio Is Associated with Early Morbidity and Mortality after Coronary Artery Bypass Grafting. Heart Surg. Forum 2015, 18, E255–E262
Navani, R.V.; Baradi, A.; Colin Huang, K.L.; Jin, D.; Jiao, Y.; Nguyen, J.K.; Ellis, Z.C.; Newcomb, A.E.; Wilson, A.M. Preoperative Platelet-to-Lymphocyte Ratio Is Not Associated with Postoperative Atrial Fibrillation. Ann. Thorac. Surg. 2020, 110, 1265–1270
İnayet Güntürk, Rifat Ozmen, Okan Ozocak, Ertuğrul Emre Güntürk, Fatma Dagli, Cevat Yazici. The Systemic Immune-Inflammation Index Predicts In-Hospital Mortality in Patients Who Underwent On-Pump Cardiac Surgery Arq Bras Cardiol. 2024; 121(4):e20230245
Hong X, Cui B, Wang M, Yang Z, et al. Systemic immune-inflammation index, based on platelet counts and neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer. Tohoku J Exp Med 2015 ;236:297-304.
Lolli C, Basso U, Derosa L, Scarpi E, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget 2016;1-8. 29
Loor G, Koch CG, Sabik JF, Li L, Blackstone EH. Implications and management of anemia in cardiac surgery: current state of knowledge. J Thorac Cardiovasc Surg. 2012;144:538 −46
Karkouti K, Wijeysundera DN, Beattie WS. Reducing Bleeding in Cardiac Surgery (RBC) Investigators. Risk associated with preoperative anemia in cardiac surgery: a multicenter cohort study.Circulation. 2008;117:478 −84
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