The Role of Systemic Immune Inflammation Index for Predicting Saphenous Vein Graft Disease in Patients with Coronary Artery Bypass Grafting

Abstract

As inflammation plays a significant role in the development of coronary artery disease, we hypothesized that there may be a relation between the systemic immune inflammation index (SII) and saphenous vein graft disease (SVGD). The study population consisted of 716 consecutive patients who underwent elective coronary angiography (CAG) >1 year after bypass grafting. The patients were divided into 2 groups depending on the extent of SVG patency. SII value was significantly higher in the SVGD(+) group compared with the SVGD(−) group ( P < .001). In multivariate logistic regression analysis, SII ( P < .001, odds ratio (OR) = 3.27, 95% CI = 1.94–5.65) and neutrophil-to-lymphocyte ratio (NLR) ( P < .001, OR = 2.08, 95% CI = 1.59–3.11) were found to be independent predictors of SVGD. An SII value of >935 (x103/ml) has 89.2% sensitivity and 70.6% specificity for the prediction of the SVGD, and an NLR value of >4.15 has 54.6% sensitivity and 68.5% specificity for the prediction of the SVGD. The AUC of SII was found to be greater than the AUC of NLR ( P = .002), platelet-to-lymphocyte ratio (PLR) ( P = .009), lymphocyte-to-monocyte ratio (LMR) ( P = .013), MPV ( P = .011), and C-reactive protein (CRP) ( P = .034) in predicting SVGD. In conclusion, we demonstrated that SII, which is among the new inflammation indexes, is a more reliable predictor in determining SVGD than the NLR, PLR, and LMR.