Usefulness of platelet to lymphocyte ratio for predicting recurrence of atrial fibrillation after direct current cardioversion

Abstract

Objective: Atrial fibrillation (AF) is the most common cardiac rhythm disorder with the associated risks of stroke and mortality. The usefulness of platelet to lymphocyte ratio (PLR), a recently described inflammatory marker, in predicting adverse cardiovascular events has been demonstrated in several studies. In the current study, we investigated the role of PLR in predicting recurrence after successful electrical cardioversion (ECV) in patients with non-valvular persistent AF.Methods: A total of 287 patients with non-valvular persistent AF achieving restoration of the sinus rhythm after successful ECV were included in this study. At study entry, complete blood count, routine biochemistry tests, and transthoracic echocardiography (TTE) were performed routinely in all subjects. Patients were followed up for 6 months following the procedure and comparisons were performed between patients who recurred and who maintained the sinus rhythm (SR).Results: At 6 months of follow-up, AF recurred in 108 patients, corresponding to a recurrence rate of 39%. Mean PLR values in the "AF recurrence group" (mean age 57.4 ± 12.0 years, 47.6% [n = 80] female) and in "SR maintenance" group (mean age 65.0 ± 9.4 years, 55.6%[n = 60] female) were 184.8 ± 44.2 and 103.3 ± 44.2, respectively, with a significant difference between the two groups (p < 0.001). In multiple regression analyses, PLR emerged as a risk factor associated with AF recurrence during the 6-month follow-up period after successful ECV (odds ratio [OR]: 3.029 (1.013-9.055 95% confidence interval [CI]), p = 0.047).When a cutoff value of 147 was used, the sensitivity and specificity of PLR for predicting AF recurrence were 83.3% and 84.5%, respectively. Conclusion:Elevated PLR is a marker of increased inflammation and may serve as a practical and inexpensive predictor for recurrence during 6 months of follow-up in patients with non-valvular persistent AF who had restoration of the sinus rhythm after successful ECV.

Platelet to lymphocyte ratio predicts all-cause mortality in patients with carotid arterial disease

“…PLR is a novel marker which indicates inflammation indirectly [14]. It has been demonstrated as an independent risk marker in many of cardiovascular diseases including coronary artery disease, heart failure, calcific aortic stenosis and atrial fibrillation [3,[15][16][17]. In addition to being a risk marker in cardiovascular field, PLR is also as a prognostic marker which shows mortality and other worse outcomes such as no-reflow phenomenon, impaired infarct artery patency, increased in hospital and short term mortality [18][19][20][21][22].…”

Prognostic value of systemic immune-inflammation index (SII) as a novel marker in patients with atrial fibrillation

“…Increasing evidence supports the essential role of inflammatory factors 10,[12][13][14] in predicting the onset of AF and recurrence. Some inflammatory factors including platelet-to-lymphocyte ratio (PLR) 15,16 , IL-6 17 , IL-10 18 and high sensitivity C-reactive protein 19 , were proven to be simple biomarkers to predict the incidence of AF in patients with or without history of AF. However, these biomarkers only involve one or two types of immune-inflammatory cells and may not accurately reflect inflammation status.…”

Value of the Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Predicting CPET Performance in Patients with Stable CAD and Recent Elective PCI

“…The platelet to lymphocyte ratio (PLR) is an integrated reflection of two important opposite inflammatory pathways that can be easily calculated from a complete blood count. PLR initially served as a prognostic biomarker in neoplastic diseases [24,25], but has recently been studied in HF [26][27][28], ACS [29][30][31][32][33], atrial fibrillation [34,35], deep venous thrombosis [36], PCI [37][38][39] and infective endocarditis [40]. The neutrophil to lymphocyte ratio (NLR) is another readily available biomarker of inflammation in cardiac and non-cardiovascular disorders [41][42][43].…”