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Simple whole blood analysis can effectively demonstrate complex changes in inflammatory responses to cardiovascular disorders in adults and enable the prediction of adverse outcomes or diminished survival. Such inflammatory activation has also been detected in the pediatric population. Blood analysis results are repeatable and readily available, which gives the method an advantage over others. Inflammatory phenomena such as a high leukocyte count and an increased neutrophil-to-lymphocyte ratio (NLR) are related to a poor prognosis of advanced heart defects and worse outcomes after pediatric cardiac surgery in the advanced stages of the disease. Surgery-associated inflammation exacerbates these diseases, and the inflammatory response may further complicate the postoperative period. Simple blood cell counts and indices may be beneficial for evaluating cardiac surgery outcomes and cardiovascular disorder prognosis in infants and children. This review summarizes current knowledge on inflammatory markers in pediatric cardiovascular diseases and surgery. [ABSTRACT FROM AUTHOR]

Background. Persistent inflammatory response after transcatheter aortic valve implantation (TAVI) is one of the possible causes of early and mid-term postprocedural adverse events. Objectives. To establish the predictive role of whole blood parameters on inflammatory response characteristics within a 1-year follow-up. Materials and methods. The study group comprised 163 consecutive patients (52.1% females), mean age 78.6 (±6.6) years (± standard deviation (SD)) who underwent TAVI and completed 1-year follow-up on-site examinations. Patients were retrospectively divided into acute kidney injury (AKI) and non-AKI subgroups. Clinical and laboratory data were collected. In-hospital and follow-up outcomes were assessed. Results. The clinical and procedural details did not show significant differences between AKI and non-AKI groups. Neutrophil-to-lymphocyte ratio (NLR) decreased from baseline to measurement after 1 year with a statistically significant decline in the whole study population and non-AKI subgroup (both p = 0.005). The baseline NLR cutoff value of 4.2 for the non-AKI group ((area under the curve (AUC) = 0.718, p < 0.0001; sensitivity 46.27%, specificity 92.31%) and of 3.8 for the AKI group (AUC = 0.673, p = 0.0174; sensitivity 59.25%, specificity 84%) had prognostic properties for persistent NLR elevation. Conclusions. The NLR decreases after TAVI, and this phenomenon is more evident in patients without AKI. Furthermore, baseline NLR cutoff values may be considered predictors of persistence of inflammatory response. [ABSTRACT FROM AUTHOR]

Introduction: Transcatheter aortic valve implantation (TAVI) although minimally invasive is still accompanied by changes in blood morphological parameters, some of them linked to unfavorable outcomes. Aim: To find any association between changes in blood morphology reflecting an inflammatory response and acute kidney injury (AKI). Material and methods: This study involved 176 consecutive transfemoral TAVI patients with a mean age of 78.4 ±7.0 years. Serum creatinine concentration (CREA) and blood morphology were analyzed in the blood samples taken before the procedure, then approximately 1, 24, 48 and 72 hours after the procedure, and lastly at the time of discharge. Post-procedural maximal or minimal values (max/min) and max/min-to-bs ratio of the laboratory parameters were also calculated. Results: Leucocyte (WBC) and neutrophil (NEUT) counts increased significantly after the procedure whereas lymphocyte (LYMPH) counts declined markedly, reaching the highest or lowest values 24 hours after the procedure. A significant increase in neutrophil-to-lymphocyte ratio (NLR) was observed. Platelet count (PLT) dropped to a minimum at 72 hours after TAVI but at discharge did not return to the admission level. TAVI was associated with a marked increase in CREA with a peak at 48 hours after the procedure (135.7 ±75.9 µM/l). Patients with AKI (n = 65; 36.9%) presented more pronounced variations in relative changes in counts of all blood morphological parameters. A positive moderate (r = 0.412) correlation between maximal NLR and relative CREA changes was noted. Conclusions: TAVI is associated with significant changes in blood morphological parameters that reflect an inflammatory response. They are more pronounced among subjects with post-procedural AKI. [ABSTRACT FROM AUTHOR]

Background: Off-pump coronary artery bypass grafting (OPCAB) is believed to limit inflammatory reaction. Neutrophil to lymphocyte ratio (NLR) is one of the more common and easily accessible markers of inflammatory response. The aim of the study was to compare postoperative results of NLR with mid-term OPCAB results. Methods: In total, 224 patients (198 (88%) men and 26 (12%) women) with mean age 65 +/- 9 years who underwent OPCAB though median full sternotomy in our department in 2018 enrolled into the study. We scrupulously collected the postoperative mid-term results, including survival rate, clinical status and risk for major adverse events, and compared them with perioperative laboratory results. Results: A three-year follow-up was completed by 198 individuals (90% survival rate) with 12 (5%) showing major adverse cardiovascular (MACE) events risk. In the multivariable analysis, the laboratory parameters noticed on the 1st postoperative day were statistically significantly predictive of survival, including neutrophils (HR 1.59, 1.33–1.89 95%CI, p < 0.0001), platelets (HR 1.01, 1.01–1.01 95%CI, p = 0.0065), NLR (HR 1.47, 1.3–1.65 95%CI, p < 0.0001) and postoperative ejection fraction (HR 0.9, 0.87–0.95 95%CI, p < 0.0001). Conclusions: Postoperative NLR above 4.6, as an inflammatory reaction marker, is related to mid-term mortality in OPCAB patients. [ABSTRACT FROM AUTHOR]

Coronary artery disease possess inflammatory background related to enzymatic processes with trace elements involvements as co-factors. The aim of the study was to compare serum, urine and salivary copper, magnesium, calcium and zinc levels with inflammatory indices obtained from the whole blood count in patients with complex coronary artery disease. Fifty-two (42(81 %) males, 10 (19 %) females) consecutive patients (mean (SD) age 68 (9) years with symptomatic complex coronary artery disease were enrolled into prospective single center study in 2021. Serum, saliva and urine samples were collected at the day of admission for trace elements concentration (copper, zinc, magnesium, calcium) and compared with inflammatory indexes obtained from preoperative and perioperative period. Multivariable regression analysis revealed relation between the copper serum concentration and neutrophil to lymphocyte ratio (NLR) and systemic inflammatory index (SII). Serum copper concentration interplay with preoperative inflammatory activation in complex coronary disease measured by NLR and SII. The copper serum concentration possesses the strongest relation to preoperative inflammatory activation in patients reffered for off-pump coronary artery bypass grafting. [ABSTRACT FROM AUTHOR]

Simple Summary: Inflammatory processes are involved in the development and progression of coronary artery disease. Environmental factors, including hyperglycaemia, hyperlipidaemia, or smoking, promote endothelial disfunction. This process generates inflammation, which further exaggerates vascular wall injury. Immune cells migrate to the endothelium after its damage and promote platelets activation. Cardiac surgery activates inflammatory response. The knowledge on the intensity of immune cells activation may enable assessment of long-term consequences, including increased morbidity and mortality. The off-pump coronary artery bypass grafting technique allows to minimize systemic inflammatory reaction; however, some extent of the response still exists and may influence surgical results. The assessment of inflammatory response has undeniable value in coronary artery disease management. Several markers have been proposed; however, indices widely available from whole blood count are most valuable in daily practice. We evaluated and proposed the use of neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR) in the prognosis of the long-term outcomes after off-pump coronary artery bypass grafting. Patients who present with abnormally increased values of pre-operative and post-operative NLR, MLR, and PLR should undergo meticulous follow-up controls, as they are burdened with a higher risk of death. Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. Method and results: The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60–71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/− 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33–4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09–2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. Conclusion: Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis. [ABSTRACT FROM AUTHOR]

(1) Background: The combination of candidate selection, immunosuppressive therapy adjustment, and scrutinous monitoring is a cornerstone for optimizing long-term survival after a heart transplant. Neutrophil-to-lymphocyte ratio (NLR) is a simple marker of inflammatory reactions activation and may play a clinical role as a predictive marker in oncological and cardiovascular diseases. The aim of the study was to find simple hematologic indices available from whole blood count to help in immunosuppressive therapy monitoring. (2) Methods: Thirty patients (23 men and 7 women) with a mean age of 43 +/− 13 years who had undergone orthotopic heart transplantation were enrolled into the study. The blood samples for whole blood count and Tacrolimus level were collected during outpatient visits in heart transplant recipients every two months for 18 months after first year post transplantation. (3) Results: There was a significant correlation between Tacrolimus overdose (>15 ng/mL) and NLR (Spearman's rho 0.99, p < 0.001) and mean platelet volume (Spearman's rho 0.989, p < 0.001). The ROC analysis for NLR above 3.62 showed predictive properties for Tacrolimus overdose (over 15 ng/mL) (AUC =0.633, p = 0.008) with a sensitivity of 50% and specificity of 83.73%. (4) Conclusions: Our results suggest that NLR above 3.62 may be regarded as a simple indicator of tacrolimus overdose. [ABSTRACT FROM AUTHOR]

Background: Off-pump coronary artery bypass grafting (OPCAB) comprises 15–30% of all bypass grafting surgeries. The currently available perioperative scores such as Euroscore and STS score do not specifically predict long-term mortality after off-pump procedures. The neutrophil-to-lymphocyte ratio (NLR) is one of the new, easily accessible markers of inflammation with proven predictive value in cardiovascular diseases. We aimed to develop the first risk score for long-term mortality after OPCAB and to determine if the perioperative value of NLR predicts long-term mortality in OPCAB patients. Methods: In total, 440 consecutive patients with multivessel stable coronary artery disease undergoing OPCAB were recruited. Differential leukocyte counts were obtained by a routine hematology analyzer. Data regarding mortality during a median follow-up time of 5.3 years were obtained from the Polish National Health Service database. An independent population of 242 patients served as a validation cohort. Results: All-cause mortality was influenced by different clinical risk factors. In multivariate regression analysis, chronic obstructive pulmonary disease, stroke history, post-operative NLR and LVEF were independent predictors of mortality. Combing all independent predictors predicted long-term all-cause mortality with 68.5% sensitivity and 71.5% specificity (AUC = 0.704, p < 0.001). After weighing these variables according to their estimates in a multivariate regression model, we developed a score to predict mortality in patients undergoing OPCAB (PREDICT-OPCAB Score, ranging from 0 to 10). Patients with a high score were at higher risk of mortality within the median 5.3 years of follow-up (score 0–3: 8.3%; 4–6: 27.0%; 7–10: 40.0%; p < 0.001 for score 0–3 vs. 4–6 and 7–10). This association was confirmed in the validation cohort. Conclusions: We developed and validated the first simplified risk score to predict mortality following OPCAB based on easily accessible clinical factors. This risk score can be used when obtaining a patient's informed consent and as an aid in determining treatment. [ABSTRACT FROM AUTHOR]