Association of Preoperative Platelet-to-Lymphocyte Ratio with Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Abstract

Objective: The aim of this study was to investigate the association between platelet-to-lymphocyte ratio (PLR) and atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. Subjects and Methods: A total of 125 patients were retrospectively analyzed. AF was diagnosed using standard clinical criteria, and PLR was calculated as the ratio of the platelets to lymphocytes, obtained from the blood samples that were taken in the fasting state before CABG surgery. The association of different variables with postoperative AF and PLR was calculated using univariate and multivariate analysis. The receiver operating characteristics curve was used to determine the sensitivity and specificity of PLR and the optimal cutoff value for predicting post-CABG AF. Results: Of the 125 patients, 50 with AF (mean age: 67.0 ± 9.5 years, 38 males and 12 females) and 75 patients without AF (mean age: 61.1 ± 9.1 years, 58 males and 17 females) were identified, and the difference in the mean age was statistically significant (p = 0.01). PLR was also significantly higher in those with AF (152.8 ± 82.2) than those without AF (118.2 ± 32.9) (p = 0.012). Univariate analysis showed that age and PLR were associated with AF after CABG surgery (p < 0.001 and p = 0.005, respectively). Using a multivariate logistic regression model with the backward elimination method, age and PLR remained as independent predictors of AF after CABG surgery (p < 0.001 and p = 0.005, respectively). PLR levels >119.3 predicted postoperative AF with 64% sensitivity and 56% specificity (AUC: 0.634, p = 0.012). Conclusion: In this study, age and PLR level were independent predictors of AF after CABG surgery. Patients with an elevated preoperative PLR were at higher risk of AF after CABG surgery.

Investigation of the Effect of HATCH Score and Coronary Artery Disease Complexity on Atrial Fibrillation after On-Pump Coronary Artery Bypass Graft Surgery

“…After coronary bypass operations, the incidence of AF varies between 20 and 45% [11, 12]. PoAF can lead to cerebrovascular events and death, and PoAF also increases the cost of treatment by extending hospital stays [13].…”

Relationship Between Platelet to Lymphocyte Ratio and Stable Coronary Artery Disease: Meta-Analysis of Observational Studies

“…27,28 Recently, this marker has been used as a prognostic marker in cardiovascular diseases, such as ACS, CAD, atrial fibrillation, and heart failure. 10,20,[29][30][31] Kurtul and Ornek assessed clinical trials to evaluate the association between PLR and cardiovascular diseases. They suggested that the PLR was a good prognostic marker to use in daily practice in patients with ACS and could be used to predict adverse outcomes and prognosis in patients with stable CAD.…”

Platelet to Lymphocyte Ratio in Cardiovascular Diseases: A Systematic Review

“…112 In addition to their role in the inflammatory cascade, it has been reported that the levels of these pro-inflammatory cytokines, along with leukocyte count and NLR, were higher in patients developing AF after CABG. 113,114 In a retrospective study, Gungor et al 115 showed that preoperative PLR and age were independently associated with AF development after CABG surgery and PLR > 119.3 predicted AF development with 64% sensitivity and 56% specificity. In another study, Altintas et al 116 aimed to evaluate whether the inflammation as measured by increased PLR predispose to silent brain infarcts (SBIs) in patients with paroxysmal AF (PAF).…”