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Can neutrophil/lymphocyte ratio predict recurrence of non-valvular atrial fibrillation after cardioversion? [Anatol J Cardiol]
Anatol J Cardiol. 2013; 13(2): 123-130 | DOI: 10.5152/akd.2013.036

Can neutrophil/lymphocyte ratio predict recurrence of non-valvular atrial fibrillation after cardioversion?

Alpay Arıbaş1, Hakan Akıllı1, Enes Elvin Gül2, Mehmet Kayrak2, Kenan Demir3, Çetin Duman4, Hajrudin Alibasiç2
1Department of Cardiology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya-Turkey
2Department of Cardiology, Faculty of Meram Medicine, Necmettin Erbakan University, Konya-Turkey
3Department of Cardiology, Faculty of Medicine, Selçuk University, Konya-Turkey
4Clinic of Cardiology, Akşehir State Hospital, Konya-Turkey

 

Objective: High neutrophil/lymphocyte ratio (NLR) has been associated with post-operative AF development in patients who underwent cardiac surgery. In this study, effectiveness of NLR for prediction of recurrence after electrical cardioversion (CV) in non-valvular AF was investigated.

Methods: A total of 149 patients who underwent a successful CV were included in this prospective cohort study. Baseline complete blood cell count, routine biochemical tests, high sensitive C-reactive protein (hs-CRP), and echocardiographic measurements were examined. After CV, patients were monitored over six months for recurrence. Baseline characteristics of recurrence group were compared with sinus rhythm group by using Student`s t -test. Logistic regression analysis was used to determine predictors of recurrence.

Results: Recurrence occurred in a total of 46 patients (30.9%). Median AF duration [16 (IQR: 14.25) vs. 12 (IQR: 11) months, p=0.01], baseline hs-CRP [9.80 (IQR: 8.50) mg/dL vs. 4.28 (IQR: 5.65) mg/dL, p=0.002] and left atrium (LA) diameter (4.5±0.4 cm,  4.3±0.5 cm, p=0.023) were significantly higher in the recurrence group than sinus rhythm group. Median NLR was comparable in recurrence and sinus groups [2.38 (IQR: 2.09) vs. 2.23, (IQR: 1.23) p=0.96, respectively].  There was a weak correlation between NLR and hs-CRP (r=0.22, p=0.05) and age (r=0.24, p=0.02). In multiple logistic regression analysis, hs-CRP [OR: 1.34 (1.09-1.65 95% CI) p=0.006], LA diameter [OR: 11.92 (1.84-77.07 95% CI) p=0.01], spontaneous echo contrast positivity, [OR: 5.40 (1.04-12.02 95% CI) p=0.045] and systolic blood pressure [OR: 1.05 (1.01-1.10 95% CI) p=0.03] were independent predictors of AF recurrence.

Conclusion: NLR failed to predict AF recurrence after a successful electrical CV, but hs-CRP remained an inflammatory marker of AF recurrence

Keywords: Atrial fibrillation, electric countershock, inflammation, recurrence, neutrophils- lymphocytes, logistic regression analysis

Alpay Arıbaş, Hakan Akıllı, Enes Elvin Gül, Mehmet Kayrak, Kenan Demir, Çetin Duman, Hajrudin Alibasiç. Can neutrophil/lymphocyte ratio predict recurrence of non-valvular atrial fibrillation after cardioversion?. Anatol J Cardiol. 2013; 13(2): 123-130