Predicting Values of Neutrophil-to-Lymphocyte Ratio (NLR), High-Sensitivity C-Reactive Protein (hs-CRP), and Left Atrial Diameter (LAD) in Patients with Nonvalvular Atrial Fibrillation Recurrence After Radiofrequency Ablation

Abstract

Background The purpose of this study was to evaluate the predictive values of lipid level, inflammatory biomarkers, and echocardiographic parameters in late NVAF (nonvalvular atrial fibrillation) recurrence after RFA (radiofrequency ablation). Material/Methods This retrospective single-center study enrolled 263 patients with paroxysmal or persistent NVAF who underwent initial RFA from Jan 2017 to Jan 2019. The patients were divided into a Recurrent group (n=70) and a Nonrecurrent group (n=193). Univariate and multivariate logistic regression analyses were used for evaluating the predictive factors of late NVAF recurrence. Receiver operating characteristic (ROC) curves were constructed to assess the predictive performance and the optimum cut-off level of variables. Results Late NVAF recurrence occurred in 70 patients (26.6%) after initial RFA within 12-month follow-up. Patients in the Recurrent group had significant higher NLR (neutrophil-to-lymphocyte ratio), hs-CRP (high-sensitivity C-reactive protein), LVEDD (left ventricular end-diastolic dimension), LVESD (left ventricular end-systolic dimension), and LAD (left atrial diameter) than those in the Nonrecurrent group ( P <0.05). In multivariate analysis, increased NLR (HR=1.438, 95% CI: 1.036–1.995, P <0.05), hs-CRP (HR=1.137, 95% CI: 1.029–1.257, P <0.05) and LAD (HR=1.089, 95% CI: 1.036–1.146, P <0.05) were independent predictors of NVAF recurrence. The area under the curve (AUC) of NLR and hs-CRP was 0.603 (95% CI 0.525–0.681) and 0.584 (95% CI 0.501–0.666), respectively. The combination of NLR, hs-CRP, and LAD revealed an AUC of 0.684 (95% CI 0.611–0.757), with cut-off values of 2.33, 2.025 ng/L, and 44.5 mm, respectively. Conclusions The combination of preoperative NLR, hs-CRP, and LAD can predict late NVAF recurrence.

Association of RDW, NLR, and PLR with Atrial Fibrillation in Critical Care Patients: A Retrospective Study Based on Propensity Score Matching

“…However, Luo et al [ 50 ] suggested that after mitral valve surgery, recurrent AF patients got a higher NLR and PLR than those nonrecurrence patients, but the diagnostic power of NLR for AF recurrence is not high (AUC = 0.643, 95%CI = 0.513-0.773, P = 0.036), and PLR was not a significant predictor of AF recurrence (AUC = 0.620, 95%CI = 0.492-0.748, P = 0.079). Similarly, Ding et al [ 51 ] reported that increased NLR was an independent predictor of nonvalvular AF recurrence vs . normal NLR after radiofrequency ablation (HR = 1.438, 95% CI: 1.036-1.995, P < 0.05).…”

Association between preablation and postablation neutrophil‐lymphocyte ratio and atrial fibrillation recurrence: A meta‐analysis

“…Out of them, two studies reported OR on AF recurrence based on delta NLR, 1,5 so both of them are excluded. The remaining seven studies [6][7][8][9][10][11][12] were included in our meta-analysis.…”

“…In our analysis, we included seven studies [6][7][8][9][10][11][12] with a total of 1923 AF patients who underwent catheter ablation. Out of 1923, 753 patients (39%) reported recurrence.…”

“…The proportion of males ranged between 35.6% and 73.4%, and the mean follow-up period varied from 3 to 30 months. Five studies are retrospective, 6,7,9,11,12 and two studies are prospective cohort studies. 8,10 All the studies included reported AF recurrence either after radiofrequency or cryoballoon catheter ablation procedures.…”

Neutrophile-Lymphocyte Ratio and Outcome in Takotsubo Syndrome

“…In ACS, high NLR has been associated with poor outcome [ 34 , 35 ]. Furthermore, NLR is associated with the risk of AF development after coronary arterial bypass surgery and radiofrequency ablation [ 36 , 37 , 38 ]. High NLR also seems to be predictive of worse outcome in patients with heart failure [ 39 ] and after valvular interventions [ 40 ].…”