Arıbaş Alpay, Akıllı Hakan, Gül Enes Elvin, Kayrak Mehmet, Demir Kenan, Duman Cetin, Alibasiç Hajrudin, Yazıcı Mehmet, Ozdemir Kurtuluş, Gök Hasan
Department of Cardiology, Faculty of Meram Medicine, Necmettin Erbakan University, Konya-Turkey.
Anadolu Kardiyol Derg. 2013 Mar;13(2):123-30. doi: 10.5152/akd.2013.036. Epub 2012 Dec 7.
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.
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.
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.
NLR failed to predict AF recurrence after a successful electrical CV, but hs-CRP remained an inflammatory marker of AF recurrence.
高中性粒细胞/淋巴细胞比值（NLR）与接受心脏手术患者术后房颤的发生有关。本研究探讨NLR对非瓣膜性房颤患者电复律（CV）后复发的预测有效性。
本前瞻性队列研究共纳入149例成功接受CV的患者。检测基线全血细胞计数、常规生化检查、高敏C反应蛋白（hs-CRP）和超声心动图测量值。CV后，对患者进行6个月的复发监测。采用Student's t检验比较复发组和窦性心律组的基线特征。采用逻辑回归分析确定复发的预测因素。
共有46例患者（30.9%）复发。复发组的房颤持续时间中位数[16（四分位间距：14.25）个月 vs. 12（四分位间距：11）个月，p=0.01]、基线hs-CRP[9.80（四分位间距：8.50）mg/dL vs. 4.28（四分位间距：5.65）mg/dL，p=0.002]和左心房（LA）直径（4.5±0.4 cm，4.3±0.5 cm，p=0.023）显著高于窦性心律组。复发组和窦性组的NLR中位数相当[分别为2.38（四分位间距：2.09）和2.23（四分位间距：1.23），p=0.96]。NLR与hs-CRP（r=0.22，p=0.05）和年龄（r=0.24，p=0.02）之间存在弱相关性。在多因素逻辑回归分析中，hs-CRP[比值比（OR）：1.34（95%置信区间：1.09 - 1.65），p=0.006]、LA直径[OR：11.92（95%置信区间：1.84 - 77.07），p=0.01]、自发显影阳性[OR：5.40（95%置信区间：1.04 - 12.02），p=0.045]和收缩压[OR：1.05（95%置信区间：1.01 - 1.10），p=0.03]是房颤复发的独立预测因素。
NLR未能预测成功电复律后房颤的复发，但hs-CRP仍然是房颤复发的炎症标志物。
