Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Am J Cardiol. 2013 Aug 15;112(4):513-9. doi: 10.1016/j.amjcard.2013.04.015. Epub 2013 May 11.
The neutrophil/lymphocyte ratio (NLR) has recently emerged as better indicator of inflammation and oxidative stress and has been widely studied in several cardiovascular diseases. In the present study, we evaluated the role of the preablation NLR in atrial fibrillation (AF) recurrence after cryoballoon-based catheter ablation. A total of 251 patients (47.8% women, age 54.12 ± 10.9 years, 80.1% with paroxysmal AF) with symptomatic AF underwent cryoablation. At a mean follow-up of 19.0 ± 6.6 months, 60 patients (23.9%) had developed AF recurrence. The patients who developed AF recurrence had had a greater preablation NLR (3.53 ± 0.95 vs 2.65 ± 0.23, p <0.001) and a higher white blood cell count, neutrophil count, and high-sensitivity C-reaction protein levels. On multivariate regression analysis, the preablation NLR (hazard ratio 2.15, 95% confidence interval 1.70 to 2.73, p <0.001), left atrial diameter (hazard ratio 1.09, 95% confidence interval 1.04 to 1.14, p <0.001) and early AF recurrence (hazard ratio 2.99, 95% confidence interval 1.71 to 5.23, p <0.001) were independent predictors of AF recurrence after cryoablation. Using a cutoff level of 3.15, the preablation NLR predicted AF recurrence during follow-up with a sensitivity of 84% and specificity of 75%. Patients with a preablation NLR >3.15 had a 2.5-fold increased risk of developing AF recurrence after cryoablation. In conclusion, an elevated preablation NLR was associated with increased AF recurrence after cryoballoon-based catheter ablation. Our results support the role of a preablation inflammatory environment in the development of AF recurrence after ablation therapy but suggest that other factors are also important.
中性粒细胞/淋巴细胞比值（NLR）最近被认为是炎症和氧化应激的更好指标，并在多种心血管疾病中得到了广泛研究。在本研究中，我们评估了消融前 NLR 在冷冻球囊导管消融后心房颤动（AF）复发中的作用。共有 251 名（47.8%为女性，年龄 54.12±10.9 岁，80.1%为阵发性 AF）有症状的 AF 患者接受了冷冻消融。平均随访 19.0±6.6 个月后，60 名（23.9%）患者发生了 AF 复发。发生 AF 复发的患者的消融前 NLR 更高（3.53±0.95 与 2.65±0.23，p<0.001），白细胞计数、中性粒细胞计数和高敏 C 反应蛋白水平更高。多变量回归分析显示，消融前 NLR（风险比 2.15，95%置信区间 1.70 至 2.73，p<0.001）、左心房直径（风险比 1.09，95%置信区间 1.04 至 1.14，p<0.001）和早期 AF 复发（风险比 2.99，95%置信区间 1.71 至 5.23，p<0.001）是冷冻消融后 AF 复发的独立预测因素。使用 3.15 的截断值，消融前 NLR 可预测随访期间 AF 复发的敏感性为 84%，特异性为 75%。消融前 NLR>3.15 的患者发生冷冻消融后 AF 复发的风险增加 2.5 倍。总之，升高的消融前 NLR 与冷冻球囊导管消融后 AF 复发增加相关。我们的结果支持消融前炎症环境在消融后 AF 复发中的作用，但表明其他因素也很重要。
