Predictive Value Of CD16~+ Monocytes For The Prognosis Of Patients With Coronary Heart Disease After The Off-pump Coronary Artery Bypass Grafting Surgery

ObjectiveTo investigate the predictive value of CD16+monocytes for the prognosis of patients with coronary heart disease?CHD?after the off-pump coronary artery bypass grafting?OPCABG?surgery.MethodsThe CHD patients who were received OPCABG surgery in Department of Cardiovascular of the First Affiliated Hospital of Anhui Medical University were enrolled.The primary endpoint was major adverse cardiac events?MACE?at 2 years follow-up.Flow cytometry?FCM?was used to detect the distribution of classical(CD14⁺⁺CD16^-),intermediate(CD14⁺⁺CD16⁺)and non-classical(CD14⁺CD16⁺⁺)monocytes in peripheral blood monocyte.The intermediate and non-classical monocytes were defined as CD16⁺monocytes.The relationship between CD16⁺monocytes and MACE occurrence was studied by COX model analysis.The ability of CD16⁺monocytes to predict MACE in CHD patients was assessed according to the Receiver operating characteristic?ROC?curve.Results?1?A total of 168 CHD patients were initially enrolled in this study,of which 155patients were in line with the study during a 2-year follow-up period.Compared with non-MACE patients,MACE patients were older?P<0.001?,more often the history of diabetes mellitus?P<0.05?,lower preoperative LVEF?P<0.001?,higher preoperative CRP and CD16⁺monocytes?P<0.001?,longer postoperative ventilator assistance time and average ICU hospitalization period?P<0.001?.?2?The postoperative average ICU hospitalization period and MACE incidence in the high CD16⁺monocytes group were significantly higher than the middle CD16⁺monocytes group and low CD16⁺monocytes group?P<0.001?.?3?Cox proportional hazards model analysis showed that CD16⁺monocytes were the independent risk factors for MACE in CHD patients after adjustment for the traditional cardiovascular risk factors?HR=1.071,95%CI1.040-1.104,P<0.001?.?4?The area under ROC curve is 0.786?95%CI 0.687-0.884,P<0.001?and the optimal cut-off point was 41.9%?70.8%sensitivity,78.6%specificity?.ConclusionCD16⁺monocytes can serve as a marker to predict the occurrence of MACE in CHD patients after the OPCABG.