Key result
Systemic Inflammation Response Index > 1.5 is linked to in-hospital death after aortic valve replacement.
Why the study?
Chronic inflammation contributes to aortic stenosis, but the predictive value of novel systemic inflammation biomarkers and leukocyte indices for early hospital events after mechanical aortic valve replacement was unclear.
Do novel biomarkers of systemic inflammation predict early hospital events in patients undergoing mechanical aortic valve replacement for aortic stenosis?
Cohort (n=363)
Do novel biomarkers of systemic inflammation predict early hospital events in patients undergoing mechanical aortic valve replacement for aortic stenosis?
p-value: p=<0.001
Systemic inflammation indices, particularly SIRI, are strong independent predictors of in-hospital mortality and bleeding following mechanical aortic valve replacement.
Introduction. The pathogenesis of aortic stenosis includes the processes of chronic inflammation, calcification, lipid metabolism disorders, and congenital structural changes. The goal of our study was to determine the predictive value of novel biomarkers of systemic inflammation and some hematological indices based on the numbers of leukocytes and their subtypes in the development of early hospital medical conditions after mechanical aortic valve replacement in patients with aortic stenosis. Materials and methods. This was a cohort study involving 363 patients who underwent surgical intervention for aortic valve pathology between 2014 and 2020. The following markers of systemic inflammation and hematological indices were studied: SIRI (Systemic Inflammation Response Index), SII (Systemic Inflammation Index), AISI (Aggregate Index of Systemic Inflammation), NLR (Neutrophil/Lymphocyte Ratio), PLR (Platelet/Lymphocyte Ratio), and MLR (Monocyte/Lymphocyte Ratio). Associations of the levels of these biomarkers and indices with the development of in-hospital death, acute kidney injury, postoperative atrial fibrillation, stroke/acute cerebrovascular accident, and bleeding were calculated. Results. According to an ROC analysis, an SIRI > 1.5 (p < 0.001), an SII > 718 (p = 0.002), an AISI > 593 (p < 0.001), an NLR > 2.48 (p < 0.001), a PLR > 132 (p = 0.004), and an MLR > 0.332 (p < 0.001) were statistically significantly associated with in-hospital death. Additionally, an SIRI > 1.5 (p < 0.001), an NLR > 2.8 (p < 0.001), and an MLR > 0.392 (p < 0.001) were associated with bleeding in the postoperative period. In a univariate logistic regression, SIRI, SII, AISI, and NLR were statistically significant independent factors associated with in-hospital death. In a multivariate logistic regression model, SIRI was the most powerful marker of systemic inflammation. Conclusion. SIRI, SII, AISI, and NLR as novel biomarkers of systemic inflammation were associated with in-hospital mortality. Of all markers and indices of systemic inflammation in our study, SIRI was the strongest predictor of a poor outcome in the multivariate regression model.
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Shvartz et al. (2023) conducted a cohort in aortic stenosis (n=363). Systemic inflammation biomarkers (SIRI, SII, AISI, NLR, PLR, MLR) was evaluated on in-hospital death (p=<0.001). Elevated systemic inflammation biomarkers, particularly a Systemic Inflammation Response Index > 1.5, were significantly associated with in-hospital death (p<0.001) after aortic valve replacement.
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