Higher preoperative SII values were associated with less favourable early postoperative parameters, including postoperative lactate and creatinine levels, mechanical ventilation duration, and ICU LOS, while AIP was associated mainly with postoperative lactate and creatinine levels, suggesting these may serve as practical adjunctive markers reflecting preoperative inflammatory and atherogenic burden.
Preoperative SII scores were significantly correlated with postoperative lactate levels in patients undergoing isolated elective CABG with CPB.
Preoperative SII scores were significantly correlated with ICU length of stay.
Preoperative SII scores were significantly correlated with duration of mechanical ventilation.
Preoperative SII scores were significantly correlated with postoperative creatinine levels.
Preoperative AIP values showed a significant positive correlation with postoperative lactate levels.
Preoperative AIP values showed a significant positive correlation with postoperative creatinine levels.
AIP did not show a significant association with ICU length of stay or duration of mechanical ventilation.
The study population had a 22% incidence of acute kidney injury in the early postoperative period.
The authors concluded that independent predictive value of SII and AIP cannot be inferred from these data and validation in larger, multicentre studies with adjusted models is needed.
This research suggests that two simple blood-test-derived scores — the Systemic Immune-Inflammation Index (SII) and the Atherogenic Index of Plasma (AIP) — measured before heart bypass surgery may be linked to how well patients recover in the early postoperative period. SII is calculated from routine blood counts (platelets, neutrophils, and lymphocytes), while AIP is calculated from a standard lipid panel (triglycerides and HDL cholesterol). In 50 patients who underwent coronary artery bypass grafting with a heart-lung machine, higher preoperative SII scores were associated with higher postoperative lactate levels (a marker of tissue stress), higher creatinine levels (a marker of kidney function), longer time on a breathing machine, and longer stays in the intensive care unit. Higher AIP scores were linked to worse lactate and creatinine values but not to ventilation time or ICU stay. About 22% of patients in this study developed acute kidney injury within the first 48 hours after surgery, which is a clinically important complication. The findings indicate that inflammatory and atherogenic burden detectable before surgery — through these two indices — may contribute to worse short-term outcomes after the physical stress of surgery and use of the cardiopulmonary bypass machine. This research is preliminary and was conducted at a single center with only 50 patients, and no statistical adjustments were made for other factors that could influence outcomes. The authors caution that these scores cannot yet be used as independent predictors of surgical outcomes, and larger, multi-center studies with more rigorous statistical methods are needed to confirm these associations. If validated, SII and AIP could offer clinicians a low-cost, readily available way to identify patients at higher risk of complications before elective coronary bypass surgery.
Göç &, Bağış M. (2026). Association of preoperative systemic immune-inflammation index and atherogenic index of plasma with early postoperative clinical outcomes in patients undergoing isolated elective coronary artery bypass grafting with cardiopulmonary bypass.. Cardiovascular journal of Africa. https://doi.org/10.5830/CVJA-2026-038