BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) comprises 15-30% of all bypass grafting surgeries. The currently available perioperative scores such as Euroscore and STS score do not specifically predict long-term mortality after off-pump procedures. The neutrophil-to-lymphocyte ratio (NLR) is one of the new, easily accessible markers of inflammation with proven predictive value in cardiovascular diseases. We aimed to develop the first risk score for long-term mortality after OPCAB and to determine if the perioperative value of NLR predicts long-term mortality in OPCAB patients. METHODS: In total, 440 consecutive patients with multivessel stable coronary artery disease undergoing OPCAB were recruited. Differential leukocyte counts were obtained by a routine hematology analyzer. Data regarding mortality during a median follow-up time of 5.3 years were obtained from the Polish National Health Service database. An independent population of 242 patients served as a validation cohort. RESULTS: All-cause mortality was influenced by different clinical risk factors. In multivariate regression analysis, chronic obstructive pulmonary disease, stroke history, post-operative NLR and LVEF were independent predictors of mortality. Combing all independent predictors predicted long-term all-cause mortality with 68.5% sensitivity and 71.5% specificity (AUC = 0.704, p < 0.001). After weighing these variables according to their estimates in a multivariate regression model, we developed a score to predict mortality in patients undergoing OPCAB (PREDICT-OPCAB Score, ranging from 0 to 10). Patients with a high score were at higher risk of mortality within the median 5.3 years of follow-up (score 0-3: 8.3%; 4-6: 27.0%; 7-10: 40.0%; p < 0.001 for score 0-3 vs. 4-6 and 7-10). This association was confirmed in the validation cohort. CONCLUSIONS: We developed and validated the first simplified risk score to predict mortality following OPCAB based on easily accessible clinical factors. This risk score can be used when obtaining a patient's informed consent and as an aid in determining treatment.
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) comprises 15-30% of all bypass grafting surgeries. The currently available perioperative scores such as Euroscore and STS score do not specifically predict long-term mortality after off-pump procedures. The neutrophil-to-lymphocyte ratio (NLR) is one of the new, easily accessible markers of inflammation with proven predictive value in cardiovascular diseases. We aimed to develop the first risk score for long-term mortality after OPCAB and to determine if the perioperative value of NLR predicts long-term mortality in OPCAB patients. METHODS: In total, 440 consecutive patients with multivessel stable coronary artery disease undergoing OPCAB were recruited. Differential leukocyte counts were obtained by a routine hematology analyzer. Data regarding mortality during a median follow-up time of 5.3 years were obtained from the Polish National Health Service database. An independent population of 242 patients served as a validation cohort. RESULTS: All-cause mortality was influenced by different clinical risk factors. In multivariate regression analysis, chronic obstructive pulmonary disease, stroke history, post-operative NLR and LVEF were independent predictors of mortality. Combing all independent predictors predicted long-term all-cause mortality with 68.5% sensitivity and 71.5% specificity (AUC = 0.704, p < 0.001). After weighing these variables according to their estimates in a multivariate regression model, we developed a score to predict mortality in patients undergoing OPCAB (PREDICT-OPCAB Score, ranging from 0 to 10). Patients with a high score were at higher risk of mortality within the median 5.3 years of follow-up (score 0-3: 8.3%; 4-6: 27.0%; 7-10: 40.0%; p < 0.001 for score 0-3 vs. 4-6 and 7-10). This association was confirmed in the validation cohort. CONCLUSIONS: We developed and validated the first simplified risk score to predict mortality following OPCAB based on easily accessible clinical factors. This risk score can be used when obtaining a patient's informed consent and as an aid in determining treatment.
Authors: Gianluigi Cuomo; Giuseppe Cioffi; Anna Di Lorenzo; Francesca Paola Iannone; Giuseppe Cudemo; Anna Maria Iannicelli; Mario Pacileo; Antonello D'Andrea; Carlo Vigorito; Gabriella Iannuzzo; Francesco Giallauria Journal: J Clin Med Date: 2022-06-06 Impact factor: 4.964
Authors: Tomasz Urbanowicz; Michał Michalak; Anna Olasińska-Wiśniewska; Michał Rodzki; Anna Witkowska; Aleksandra Gąsecka; Piotr Buczkowski; Bartłomiej Perek; Marek Jemielity Journal: Cells Date: 2022-03-26 Impact factor: 6.600
Authors: Tomasz Urbanowicz; Michał Michalak; Anna Olasińska-Wiśniewska; Anna Witkowska; Michał Rodzki; Ewelina Błażejowska; Aleksandra Gąsecka; Bartłomiej Perek; Marek Jemielity Journal: Medicina (Kaunas) Date: 2021-12-03 Impact factor: 2.430
Authors: Tomasz Urbanowicz; Anna Olasińska-Wiśniewska; Michał Michalak; Michał Rodzki; Anna Witkowska; Ewa Straburzyńska-Migaj; Bartłomiej Perek; Marek Jemielity Journal: Biology (Basel) Date: 2021-12-27
Authors: Tomasz Urbanowicz; Michał Michalak; Ahmed Al-Imam; Anna Olasińska-Wiśniewska; Michał Rodzki; Anna Witkowska; Assad Haneya; Piotr Buczkowski; Bartłomiej Perek; Marek Jemielity Journal: Diagnostics (Basel) Date: 2022-03-04