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      Systemic immune-inflammation index as a novel predictor of atrial fibrillation after off-pump coronary artery bypass grafting

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          SUMMARY

          OBJECTIVE:

          This study aims to examine the predictive role of systemic immune-inflammation index on postoperative new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting.

          METHODS:

          A total of 722 patients undergoing elective off-pump coronary artery bypass grafting between January 2017 and September 2021 were included in this study and divided into two groups as the atrial fibrillation group (n=172) and the non-atrial fibrillation group (n=550). Both groups were compared in terms of patients’ baseline clinical features, operative and postoperative variables, and preoperative hematological indices derived from the complete blood count analysis. Multivariate logistic regression and receiver-operating characteristic curve analyses were performed to detect the independent predictors of postoperative new-onset atrial fibrillation.

          RESULTS:

          The median age and length of hospital stay in the atrial fibrillation group were significantly higher than those in the non-atrial fibrillation group. The median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammation in the atrial fibrillation group were significantly greater than in those in the non- atrial fibrillation group. Logistic regression analysis demonstrated that age, platelet, platelet/lymphocyte ratio, and systemic immune-inflammation were independent predictors of postoperative new-onset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7×10 3/mm 3 constituted cut-off value to predict the occurrence of new-onset atrial fibrillation with 86.6% sensitivity and 29.3% specificity.

          CONCLUSION:

          Our study revealed for the first time that systemic immune-inflammation predicted new-onset atrial fibrillation after off-pump coronary artery bypass grafting.

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          Most cited references24

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          R: A language and environmentfor statistical computing

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            Systemic immune‐inflammation index (SII) predicted clinical outcome in patients with coronary artery disease

            This study examines the predictive value of a novel systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio) in coronary artery disease (CAD) patients.
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              Prognostic value of Systemic immune-inflammation index in cancer: A meta-analysis

              Systemic immune-inflammation index (SII), on the basis of lymphocyte, neutrophil and platelet counts had been published to be a good prognostic factor in multiple cancers. Nevertheless, the prognostic value of SII in cancer patients remains inconsistent. Therefore, we carried out a meta-analysis to evaluate the prognostic value of SII in these patients with cancer. A total of 22 articles with 7657 patients enrolled in this meta-analysis. The combined result revealed that a high SII was evidently correlated with poor overall survival (OS) (HR=1.69, 95%CI=1.42-2.01, p<0.001), poor time to recurrent (TTR) (HR=1.87, p<0.001) , poor progress-free survival (PFS) (HR=1.61, p=0.012) ,poor cancer-specific survival (CSS) (HR=1.44, p=0.027) , poor relapse-free survival (RFS) (HR=1.66, p=0.025) and poor disease-free survival (DFS) (HR=2.70, p<0.001) in patients with cancers. Subgroup analysis indicated that SII over the cutoff value could predict worse overall survival in Hepatocellular carcinoma (p<0.001), Gastric cancer (p=0.005), Esophageal Squamous Cell Carcinoma (p=0.013), Urinary system cancer (p<0.001), Small cell lung cancer (p<0.001), Non-Small cell lung cancer (p<0.001) and Acral Melanoma (p<0.001). The largest effect size was observed in the Hepatocellular carcinoma (HR=2.11). In addition, these associations did not vary significantly by the cutoff value, sample size and ethnicity. Therefore, high SII may be a potential prognostic marker in patients with various cancers and associated with the poor overall outcomes.
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                Author and article information

                Contributors
                Role: Data curation, Formal Analysis, Writing – original draft, Writing – review & editing
                Role: Conceptualization, Data curation, Formal Analysis, Writing – original draft, Writing – review & editing
                Role: Conceptualization, Data curation, Formal Analysis, Writing – review & editing
                Role: Conceptualization, Data curation, Formal Analysis, Writing – original draft
                Role: Conceptualization, Data curation, Formal Analysis, Writing – review & editing
                Role: Data curation, Writing – review & editing
                Role: Formal Analysis, Writing – review & editing
                Journal
                Rev Assoc Med Bras (1992)
                Rev Assoc Med Bras (1992)
                ramb
                Revista da Associação Médica Brasileira
                Associação Médica Brasileira
                0104-4230
                1806-9282
                07 October 2022
                September 2022
                : 68
                : 9
                : 1240-1246
                Affiliations
                [1 ]Bursa City Hospital, Department of Cardiology – Bursa, Turkey.
                [2 ]Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Cardiovascular Surgery – Bolu, Turkey.
                [3 ]Bursa City Hospital, Department of Cardiovascular Surgery – Bursa, Turkey.
                [4 ]Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Cardiology – Bolu, Turkey.
                [5 ]Bolu Abant Izzet Baysal University, Faculty of Medicine, Department of Biostatistics – Bolu, Turkey.
                Author notes
                [* ]Corresponding author: drdursuntopal@ 123456hotmail.com

                Conflicts of interest: the authors declare there is no conflicts of interest.

                Author information
                http://orcid.org/0000-0002-3779-2297
                http://orcid.org/0000-0002-6107-2943
                http://orcid.org/0000-0003-4709-4705
                http://orcid.org/0000-0003-0021-6509
                http://orcid.org/0000-0002-6913-9073
                http://orcid.org/0000-0003-3655-1595
                http://orcid.org/0000-0003-4791-8946
                Article
                1806-9282.20220295
                10.1590/1806-9282.20220295
                9575030
                36228255
                5244a830-d689-469a-9656-cd10ab1ce525

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 May 2022
                : 01 July 2022
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 21, Pages: 7
                Categories
                Original Article

                atrial fibrillation,off pump coronary artery bypass

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