Cardiovascular Journal of Africa: Vol 34 No 4 (SEPTEMBER/OCTOBER 2023)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 4, September/October 2023 204 AFRICA bias with multivariate statistical methods and adjusted for risk factors that affect postoperative AKI, we could not eliminate the potential for residual confounding. In the absence of a comparable prospective database of AKI after cardiac surgery, a retrospective study with compensatory statistical methods is a reasonable approach. Second, this was a single-centre study with a relatively small sample size. Third, we did not have data about the severity of the disease at the time of admission to ICU. Even though there may have been inaccuracy and differences in data, we assumed that these were distributed randomly and would not result in an important bias in our results. Fourth, we did not have access to information regarding the subsequent medical care of these patients. Fifth, CIMT was measured at a single time point. In studies where progression of CIMT was taken into account, which is suggested to vary in different segments of the carotid arteries, finding similar results becomes unclear if changes in internal carotid artery intima– media thickness (I-IMT) compared to CCA-IMT in time were considered. Sixth, when CCA-IMT and I-IMT are compared to assess prediction of AKI risk following cardiac surgery, use of a more modern ultrasound technology with smaller variability and enhanced resolution may result in different values. Seventh, non-traditional risk factors for increase in CIMT were not assessed in this study. Finally, although we could not establish a causal relationship in this study, the results may have some clinical implications if confirmed by large-scale prospective studies. Therefore, CIMT may not lose its predictive power in terms of AKI prediction in larger patient groups and patients with acute pre-operative events. Conclusion We observed that elevated CRP, ESR, PLR, NLR and CIMT were independent predictors of early postoperative AKI following isolated CABG. These findings suggest that the factors proven to be related to inflammation may predict adverse events following CABG. As a measurable morphological change that is related to both AKI and the inflammatory burden, CIMT may be considered a predictor that can be used more widely than pre-operative blood tests. We hope that our study may be useful in providing more evidence on the effectiveness and applicability of this marker. References 1. Chimonas T, Fanouraki I, Liberopoulos EN, et al. Diverging trends in cardiovascular morbidity and mortality in a low-risk population. Eur J Epidemiol 2009; 24(8): 415–423. 2. Ziyrek M, Tayyareci Y, Yurdakul S, et al. Association of mitral annular calcification with endothelial dysfunction, carotid intima–media thickness and serum fetuin-A: an observational study. 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