Department of Cardiology, Assuta Ashdod University Medical Center, Ben-Gurion University of the Negev, Ashdod, Israel.
Jesselson Integrated Heart Center, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
Int J Lab Hematol. 2021 Aug;43(4):602-608. doi: 10.1111/ijlh.13426. Epub 2020 Dec 8.
Atrial fibrillation (AF) is associated with platelet hyperactivity and a higher proportion of immature platelets. We aimed to examine whether immature platelet fraction (IPF) and inflammatory markers differ between AF types and whether they are affected by ablation.
A prospective study included patients with atrial fibrillation/flutter (AFL). We excluded patients with hematologic, inflammatory, or acute coronary states. Blood samples for IPF, white blood cells (WBC), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP) were collected at baseline, within one-hour postablation in those undergoing ablations, and the day after ablation. IPF was measured by an autoanalyzer (Sysmex 2100 XE).
One hundred and four patients were included (paroxysmal AF-63, persistent AF-36, AF and AFL-7, AFL alone-5), (Mean age 67.7 ± 12.8 years, 54.8% male, CHA D -VASC 3.2 ± 1.8). Seventy-two patients underwent ablation (cryoballoon AF ablation-60, AFL radiofrequency ablation-5, both-7). There was no difference between paroxysmal and persistent AF regarding baseline markers. There was a significant change in the following parameters after ablation: WBC (baseline 6.9 ± 2.0, 1-h post 8.0 ± 2.4, and 1-day post 9.0 ± 2.8 ×10 /L), NLR (2.9 ± 2.2, 3.0 ± 2.4, 4.2 ± 2.9, respectively), and CRP (3.6 ± 3.7, 3.6 ± 3.5, 12.4 ± 9.0 mg/L, respectively) (P < .05 for all). However, there were no differences in immature platelet count (8.6 ± 4.8, 8.5 ± 4.9, 8.4 ± 5.2 ×10 /L) or IPF (4.6 ± 3.2, 4.7 ± 3.3, 4.9 ± 3.6%) from baseline to postablation (p = NS).
AF persistency does not affect IPF and inflammation. In patients undergoing cryoablation of AF, there is a postablation inflammatory process; however, platelet activation is probably not affected.
心房颤动(AF)与血小板活性增强和未成熟血小板比例增加有关。我们旨在研究 AF 类型之间的未成熟血小板分数(IPF)和炎症标志物是否不同,以及它们是否受消融的影响。
一项前瞻性研究纳入了心房颤动/扑动(AFL)患者。我们排除了有血液学、炎症或急性冠状动脉状态的患者。在接受消融治疗的患者中,在消融后 1 小时内和消融后第 1 天采集血液样本,用于检测 IPF、白细胞(WBC)、中性粒细胞与淋巴细胞比值(NLR)和 C 反应蛋白(CRP)。IPF 通过自动分析仪(Sysmex 2100 XE)测量。
共纳入 104 例患者(阵发性 AF-63 例,持续性 AF-36 例,AF 和 AFL-7 例,AFL 单独-5 例)(平均年龄 67.7±12.8 岁,54.8%为男性,CHA2D2-VASc 3.2±1.8)。72 例患者接受了消融治疗(冷冻球囊消融 AF-60 例,AFL 射频消融-5 例,两者均有-7 例)。阵发性和持续性 AF 在基线标志物方面没有差异。消融后以下参数发生显著变化:白细胞(基线 6.9±2.0,1 小时后 8.0±2.4,1 天后 9.0±2.8×109/L)、NLR(2.9±2.2,3.0±2.4,4.2±2.9),CRP(3.6±3.7,3.6±3.5,12.4±9.0mg/L)(均 P<.05)。然而,从基线到消融后,未成熟血小板计数(8.6±4.8,8.5±4.9,8.4±5.2×109/L)或 IPF(4.6±3.2,4.7±3.3,4.9±3.6%)均无差异(p=NS)。
AF 持续时间不影响 IPF 和炎症。在接受 AF 冷冻消融的患者中,存在消融后的炎症反应;然而,血小板激活可能不受影响。