Pan-Immune-Inflammation Value: A Novel Biomarker for Predicting Postoperative Atrial Fibrillation in Young Patients Undergoing Off-Pump CABG.

Abstract

Objectives: To the best of our knowledge, the possible predictive relationship between pan-immune-inflammation value (PIV) and new-onset atrial fibrillation (AF) following off-pump coronary artery bypass grafting (CABG) has not yet been examined in the literature. Therefore, we aimed to examine whether there was a predictive relationship of PIV with new-onset AF in young patients undergoing off-pump CABG.

Design: A retrospective observational cohort study.

Setting: Tertiary referral hospital in Turkey.

Participants: A total of 223 young patients (age ≤50 years) undergoing off-pump CABG.

Interventions: The patients were categorized into two groups as AF group (n = 31) and non-AF group (n = 192). The groups were compared with regard to preoperative basic clinical features, laboratory parameters, and operative and postoperative data of patients. Following univariate analyses, logistic regression analysis was conducted to identify independent predictors of postoperative new-onset AF, and receiver-operating characteristic curve analyses were conducted to determine the optimum cut-off values of identified independent predictors. PIV measurement was the primary outcome of the study.

Measurements and main results: No significant differences were found between the groups with regard to preoperative basic clinical features and operative and postoperative data, except for length of hospital stay. There were statistically significant differences between the groups in terms of platelet, neutrophil, lymphocyte, and monocyte counts as well as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and PIV. In logistic regression analysis, PIV and NLR were detected to be significant hematological variables, and thus these indices were considered independent predictors of postoperative new-onset AF (odds ratio 1.001, 95% CI 1.000-1.002 for PIV). Receiver-operating characteristic analysis revealed that for predicting postoperative AF, PIV of 307.9 constituted the optimum cut-off value with 93.5% sensitivity and 71.4% specificity rates.

Conclusion: Our study demonstrated for the first time in the literature that the PIV and the NLR significantly and independently predicted new-onset AF following off-pump CABG.