Predictive value of inflammatory indices for one year outcome of primary percutaneous coronary intervention on saphenous vein graft in post-coronary artery bypass grafting patients

BACKGROUND: This study aims to evaluate the prognostic value of the inflammatory indices i.e. Platelet Lymphocyte Ratio (PLR), Neutrophil Lymphocyte Ratio (NLR), and Systemic Immune Inflammation Index (SII) as potential predictors of Major Adverse Cardiovascular Event (MACE) in patients undergoing Primary Percutaneous Coronary Intervention (PPCI) on Saphenous Vein Graft (SVG) with a history of Coronary Artery Bypass Graft (CABG). METHODS: This retrospective study evaluated 74 patients who underwent PPCI on SVG at a tertiary centre between 2015-2023. Patients were divided based on experiencing MACE within one year. Baseline characteristics and inflammatory markers were compared between groups. Logistic regression identified predictors of MACE. RESULTS: Of these 78, 74 completed the one-year follow-up and were included in the analysis. MACE occurred in 24 patients. We divided patients into two groups based on the occurrence of MACE. The MACE group had a significantly higher pre-procedural PLR compared to others (Mean difference [95%CI]: 22.24 [1.39, 42.23], p-value: 0.0346), while pre-procedural NLR, and SII, and post-procedural PLR, NLR, and SII were comparable between groups. Left Ventricular Ejection Fraction (LVEF) and pre-procedural PLR were predictors of one-year MACE; however, with low odds ratios (Odds Ratio [95%CI]: 0.91 [0.86, 0.96], 1.02 [1.00, 1.03], respectively). Only LVEF was an independent predictor of MACE. LVEF yielded a better discriminatory power than pre-procedural PLR. Pre-procedural PLR > 104.18 yielded a 70% sensitivity at 54% specificity for one-year MACE. CONCLUSION: Pre-procedural PLR and LVEF might be a predictor of one-year MACE following PPCI on SVG in post-CABG patients.