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Introduction: Mean platelet volume (MPV) is claimed to be a useful marker to predict long-term risk for major adverse cardiac effects (MACE) in patients undergoing percutaneous coronary interventions (PCI). Aim: To explore the possible dependence on MPV and postoperative PCI risk in patients with complex coronary artery disease undergoing coronary artery bypass grafting in off-pump technique (OPCAB). Material and methods: We retrospectively analyzed 236 consecutive patients (180 (76%) males and 56 (24%) women) referred for surgery due to complex coronary artery disease between 2015 and 2016 in our department. The mean 5.1 ±0.8 year follow-up included profound analysis of MACE events including acute coronary syndromes and percutaneous interventions. Results: The 5 ±1 year follow-up was completed by 213 (90%) patients with 2 (1%) deaths within the first year after surgery. In logistic univariate and multivariate model regression analysis two parameters were found significant, i.e. preoperative white blood cells and postoperative MVP, for PCI risk in long-term follow-up. The odds ratio values for postoperative MPV were 1.78 (95% CI, p = 0.0036) and 1.76 (95% CI, p = 0.005) in univariate and multivariate models with cutoff point > 8.7, sensitivity 45.65%, specificity 78.72%. Conclusions: MPV can be regarded as a simple marker of PCI risk following OPCAB procedures. The preoperative MPV indicates the individual tendency for worse prognosis more than procedure dependence. [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]