Association of the Systemic Glucose–Inflammation Index with postoperative cerebral infarction after off‐pump coronary artery bypass surgery

Inflammatory processes and glycemic dysregulation are recognized contributors to poor cerebrovascular and cardiovascular events. This study proposed a new composite indicator, the systemic glucose–inflammation index (SGI) and evaluated its capacity to predict postoperative cerebral infarction among individuals who underwent off‐pump coronary artery bypass grafting (OPCABG). Our cohort comprised 6549 patients undergoing elective OPCABG from January 2021 to October 2022 across eight medical centers in China. The primary outcome was in‐hospital postoperative cerebral infarction, with secondary outcomes including in‐hospital death and acute kidney injury (AKI) and postoperative myocardial infarction. We employed logistic regression modeling and restricted cubic spline (RCS) techniques to examine the relationship between SGI levels and endpoint events. The SGI was derived using the formula: [fasting blood glucose × platelet count]/admission white blood cell count. Stroke after OPCABG developed in 136 participants (2.08%). Patients in the uppermost SGI quartile had markedly elevated stroke rates compared to those in the lowest quartile (3.54% vs. 1.10%, p < 0.001). After multivariable adjustment, the SGI remained independently correlated with stroke risk (OR = 1.28, p < 0.001). RCS analysis showed that the association between the SGI and postoperative stroke was consistent with a linear relationship ( p for nonlinearity = 0.076). The SGI is an independent prognostic marker for stroke following OPCABG. Incorporating the SGI into established risk evaluation frameworks may enhance predictive value.