ÖZGE ÇAKMAK KARAASLAN, GİZEM GİRGİN DİRLİKTUTAN, ZEYNEP KAPLAN, MURAT OĞUZ ÖZİLHAN, ÜMİT GÜRAY
Journal of Updates in Cardiovascular Medicine - 2025;13(2):115-125
Objectives Lead extraction is a critical procedure for managing complications in patients with cardiovascular implantable electronic devices. The potential predictive value of inflammatory indices, such as the systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and prognostic nutritional index (PNI), in determining procedural outcomes remains unclear. This study aimed to evaluate the relationship between complications following lead extraction and inflammatory indices in patients undergoing the procedure, with a particular focus on those treated for infectious versus non-infectious causes. Materials and Methods This retrospective, single-center study analyzed patients who underwent lead extraction between 2019 and 2020. Complications, including hematoma, pericardial effusion, and sudden cardiac death, were assessed. Multivariate logistic regression identified predictors of adverse outcomes, and ROC curve analysis evaluated the predictive value of SII, PIV, and PNI. RESULTS Among the 234 patients included (mean age 62, 81% male), complications occurred in 25.6% (n=60), with mortality recorded in 3.8%. Hematoma and pericardial effusion were observed in 12% and 14.5% of patients, respectively. ROC analysis revealed no significant association between the inflammatory indices (SII, PIV, PNI) and complications. Multivariate logistic regression identified diabetes mellitus (DM) as a significant independent predictor of complications (p<0.05). No differences in outcomes were noted between infectious and non-infectious lead extraction subgroups. CONCLUSION While inflammatory indices showed limited predictive utility, DM emerged as a critical risk factor for complications following lead extraction. Comprehensive preprocedural risk stratification, with attention to metabolic conditions such as diabetes, is essential to improving procedural outcomes. Further studies are needed to refine predictive models incorporating both systemic and procedure-specific variables.
