Weymann Alexander, Ali-Hasan-Al-Saegh Sadeq, Sabashnikov Anton, Popov Aron-Frederik, Mirhosseini Seyed Jalil, Liu Tong, Lotfaliani Mohammadreza, Sá Michel Pompeu Barros de Oliveira, Baker William L L, Yavuz Senol, Zeriouh Mohamed, Jang Jae-Sik, Dehghan Hamidreza, Meng Lei, Testa Luca, D'Ascenzo Fabrizio, Benedetto Umberto, Tse Gary, Nombela-Franco Luis, Dohmen Pascal M, Deshmukh Abhishek J, Linde Cecilia, Biondi-Zoccai Giuseppe, Stone Gregg W, Calkins Hugh, Surgery And Cardiology-Group Imcsc-Group Integrated Meta-Analysis Of Cardiac
Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Afshar Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Med Sci Monit Basic Res. 2017 May 12;23:179-222. doi: 10.12659/msmbr.903320.
BACKGROUND Atrial fibrillation (AF) is one of the most critical and frequent arrhythmias precipitating morbidities and mortalities. The complete blood count (CBC) test is an important blood test in clinical practice and is routinely used in the workup of cardiovascular diseases. This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of hematological parameters in the CBC test with new-onset and recurrent AF. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating hematologic parameters in patients with new-onset AF and recurrent AF. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity. RESULTS The literature search of all major databases retrieved 2150 studies. After screening, 70 studies were analyzed in the meta-analysis on new-onset AF and 23 studies on recurrent AF. Pooled analysis on new-onset AF showed platelet count (PC) (weighted mean difference (WMD)=WMD of -26.39×10^9/L and p<0.001), mean platelet volume (MPV) (WMD=0.42 FL and p<0.001), white blood cell (WBC) (WMD=-0.005×10^9/L and p=0.83), neutrophil to lymphocyte ratio (NLR) (WMD=0.89 and p<0.001), and red blood cell distribution width (RDW) (WMD=0.61% and p<0.001) as associated factors. Pooled analysis on recurrent AF revealed PC (WMD=-2.71×109/L and p=0.59), WBC (WMD=0.20×10^9/L (95% CI: 0.08 to 0.32; p=0.002), NLR (WMD=0.37 and p<0.001), and RDW (WMD=0.28% and p<0.001). CONCLUSIONS Hematological parameters have significant ability to predict occurrence and recurrence of AF. Therefore, emphasizing the potential predictive role of hematological parameters for new-onset and recurrent AF, we recommend adding the CBC test to the diagnostic modalities of AF in clinical practice.
心房颤动（AF）是导致发病和死亡的最严重且最常见的心律失常之一。全血细胞计数（CBC）检测是临床实践中的一项重要血液检测，常用于心血管疾病的检查。这项系统评价及荟萃分析旨在确定评估CBC检测中的血液学参数与新发和复发AF之间关联的证据强度。
我们对评估新发AF和复发AF患者血液学参数的观察性研究进行了荟萃分析。进行了全面的亚组分析以探索异质性的潜在来源。
对所有主要数据库的文献检索共获取2150项研究。筛选后，70项研究纳入新发AF的荟萃分析，23项研究纳入复发AF的荟萃分析。新发AF的汇总分析显示血小板计数（PC）（加权均数差（WMD）=-26.39×10^9/L，p<0.001）、平均血小板体积（MPV）（WMD=0.42 FL，p<0.001）、白细胞（WBC）（WMD=-0.005×10^9/L，p=0.83）、中性粒细胞与淋巴细胞比值（NLR）（WMD=0.89，p<0.001）以及红细胞分布宽度（RDW）（WMD=0.61%，p<0.001）为相关因素。复发AF的汇总分析显示PC（WMD=-2.71×10^9/L，p=0.59）、WBC（WMD=0.20×10^9/L（95%CI：0.08至0.32；p=0.002）、NLR（WMD=0.37，p<0.001）以及RDW（WMD=0.28%，p<0.001）。
血液学参数具有预测AF发生和复发的显著能力。因此，鉴于强调血液学参数对新发和复发AF的潜在预测作用，我们建议在临床实践中将CBC检测纳入AF的诊断方法中。
