Association of Aortic Cross-Clamping Time with Systemic Immune Inflammation and Systemic Inflammatory Response Indexes in Isolated Coronary Bypass Surgery.

Introduction: Prolonged aortic cross-clamping may intensify systemic inflammation after cardiac surgery. This study aimed to evaluate the effect of cross-clamp duration on systemic inflammatory response index (SIRI) and systemic immune inflammation index (SIII) in isolated coronary artery bypass grafting (CABG).

Method: This retrospective study included 155 patients who underwent first-time isolated CABG between January 2021 and June 2024. Patients were divided into two groups based on median cross-clamping time: Group I (≤ 64 minutes, n = 83) and Group II (> 64 minutes, n = 72). Demographic, hematologic, and biochemical data were collected. SIII was calculated as platelet × neutrophil/lymphocyte; SIRI as neutrophil × monocyte/lymphocyte.

Results: The mean aortic cross-clamping time of Group I was 53 minutes (interquartile range 44 - 60 minutes) and of Group II it was 78 minutes (interquartile range 71 - 87 minutes) (P < 0.001). An increase in systemic immune inflammation index and systemic inflammatory response index values was observed in both groups at the 24th postoperative hour. Postoperative systemic immune inflammation index and systemic inflammatory response index levels were significantly higher in Group II (P < 0.05). There was a weak but significant positive correlation between aortic cross-clamping time and postoperative systemic inflammation response index (r = 0.220; P = 0.006).

Conclusion: Prolonged aortic cross-clamping time is associated with an increased postoperative inflammatory response. These indices may serve as biomarkers for evaluating systemic inflammation following coronary artery bypass grafting.