Usefulness of Neutrophil/Lymphocyte Ratio As Predictor of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting

Gibson, Patrick; Cuthbertson, Brian H.; Croal, Bernard; Rae, D. O.; El-Shafei, Hussein; Gibson, George A.; Jeffrey, Robert R.; Buchan, Keith; Hillis, Graham S.

doi:10.1016/j.amjcard.2009.09.007

Cited by 266 publications

(233 citation statements)

References 21 publications

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“…Studies in different cardiac conditions evaluating different endpoints have showed different values. NLR AUC in our study in HTX showed better performance for in‐hospital mortality compared with the AUC for predicting major adverse cardiovascular events after percutaneous coronary interventions,26 or saphenous vein graft disease,27 and atrial fibrillation20 after CABG. On the contrary, other studies have showed better NLR AUC for mortality both in HF28, 29 and in non‐ST elevation myocardial infarction 30.…”

Section: Discussionmentioning

confidence: 64%

“…Most studies evaluating NLR and PLR for cardiac surgery showed predictive value of these markers before surgery,19 similar to our study in HTX. One study, however, showed that both pre‐operative and post‐operative (48 h) higher NLR values were associated new atrial fibrillation in patients undergoing CABG 20. Another study in patients undergoing transcatheter aortic valve replacement showed that higher increase in NLR after valve implantation was associated with worse survival 21.…”

Section: Discussionmentioning

confidence: 99%

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Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

et al. 2017

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AimsThe aim of this study was to evaluate whether neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) predict outcome in heart failure (HF) patients undergoing heart transplantation (HTX).Methods and resultsData from 111 HF patients undergoing HTX 2010–2015 were retrospectively reviewed. NLR and PLR were calculated before HTX, immediately after HTX, and at 6 and 24 hours. Primary endpoint was in‐hospital mortality, and secondary endpoints were 1 year mortality and renal replacement therapy (RRT). Prognostic factors were assessed by multivariate analysis, and the predictive values of NLR and PLR for mortality were compared. The discriminatory performance for predicting in‐hospital mortality was better for NLR [area under the receiver operating characteristic curve (AUC) = 0.644, 95% confidence interval 0.492–0.797] than for PLR (AUC = 0.599, 95% confidence interval 0.423–0.776). Best cut‐off value was 2.41 for NLR (sensitivity 86%, specificity 67%) and 92.5 for PLR (sensitivity 86%, specificity 68%). When divided according to best cut‐off value, in‐hospital mortality was significantly higher in the high NLR group (17.5% vs. 3.2%, P < 0.05), but not in the high PLR group (16.5% vs. 6.3%, P = ns). One year mortality was not significantly higher for either group (37.5% vs. 6.5% for NLR; 36.7% vs. 9.4% for PLR, P = ns for both), while RRT was significantly higher in both the NLR and PLR high groups (33.8% vs. 0%; 32.9% vs. 3.1%, respectively, P < 0.001). Multivariate analysis indicated that only high NLR (hazard ratio = 3.403, P < 0.05) and pre‐transplant diabetes (hazard ratio = 3.364, P < 0.05) were independent prognostic factors for 1 year mortality.ConclusionsHigh NLR was a predictor for in‐hospital mortality, and an independent prognostic factor for 1 year mortality. Both high NLR and high PLR were predictors for RRT.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

et al. 2017

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“…14,15 Furthermore, a high preoperative NLR was related to an increased incidence of AF in coronary artery bypass grafting patients after surgery. 16 In a study of a patient population with diabetes, the NLR was significantly higher in an AF group than an AF-free group, and it was an independent risk factor for AF. 17 A similar study found that NLR was higher in persistent/permanent NVAF patients than in cases of paroxysmal AF.…”

Section: Discussionmentioning

confidence: 96%

Use of neutrophil‐lymphocyte ratio for risk stratification and relationship with time in therapeutic range in patients with nonvalvular atrial fibrillation: A pilot study

Coşansu

Vatan

Gündüz

et al. 2018

Clinical Cardiology

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BackgroundAtrial fibrillation is one of the most common abnormal heart rhythms. Neutrophil‐lymphocyte ratio (NLR) has emerged as a potential marker for the level of inflammation in cardiac disorders.HypothesisNLR might be associated with thrombosis and bleeding risk scores and might predict cardioembolic risk in nonvalvular atrial fibrillation (NVAF) patients within the therapeutic international normalized ratio (INR).MethodsWe enrolled 272 patients taking warfarin for NVAF and classified them into 2 groups: Group A consisted of patients (n = 132) whose time in therapeutic range (TTR) was ≥65%, and Group B comprised patients (n = 139) whose TTR was <65%.ResultsNLR values were higher in group B than in group A (P < 0.0001). Patients classified as high risk according to CHA2DS2‐VASc score had significantly higher NLR levels (P = 0.002) than those classified as low and intermediate risk. Furthermore, NLR levels were significantly correlated with CHA2DS2‐VASc and HAS‐BLED scores (P < 0.001 and P < 0.0001, respectively). NLR predicted patients within therapeutic INR range (TTR ≥65%) with sensitivity of 81% and specificity of 71% in a receiver operator characteristic curve analysis, using a cutoff value of 2.17. Area under the curve for NLR was 0.81 (P < 0.0001).ConclusionsTo our knowledge, this is the first study showing correlation of NLR with both CHA2DS2‐VASc and HAS‐BLED risk scores. NLR might represent a useful marker to identify patients with high risks of stroke and bleeding and may have predictive value in identifying patients within the therapeutic INR range.

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“…The neutrophil to lymphocyte ratio (NLR) which can be derived from the white blood cell count is an inexpensive, routinely used, reproducible test. NLR has been proposed as a novel biomarker for systemic infl ammatory response in several diseases (10)(11)(12)(13). Previous studies have shown that NLR is associated with poor clinical outcomes in CVD and it is also a predictor for CVD (10,12).…”

Section: Introductionmentioning

confidence: 99%

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Sünbül¹,

Sünbül²,

Kanar³

et al. 2015

BLL

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BACKGROUND: Obstructive sleep apnea (OSA) is characterized by reductions in breathing amplitude during sleep caused by an obstructed or collapsed upper airway. The neutrophil to lymphocyte ratio (NLR) has been proposed as a novel biomarker for systemic infl ammatory response. The aim of the present study was to evaluate the relationship between NLR and OSA. METHODS: The study population consisted of 195 consecutive patients with clinical suspicion of OSA. Full night polysomnography was performed for all patients. Patients with an apnea hypopnea index (AHI) ≥ 5 were considered to have OSA. NLR was calculated as the ratio of neutrophil count to lymphocyte count. RESULTS: While 130 patients (91 male, mean age: 49.9±9.8 years) had OSA, 65 patients (42 male, mean age: 48.7 ± 10.2 years) had normal fi ndings according to AHI scores. Cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking were more common in patients with OSA. Patients with OSA had signifi cantly higher NLR than controls (1.87±0.80 vs 1.49±0.48, p=0.005). AHI score was signifi cantly correlated with NLR (r=0.228, p=0.001). NLR and presence of hyperlipidemia were independent predictors of OSA (OR: 2.451, 2.850, p=0.001, 0.004, respectively). NLR of 1.62 or higher predicted OSA with a sensitivity of 56.2 % and specifi city of 63.1 %. CONCLUSIONS: NLR was higher and also correlated with AHI score in patients with OSA which has not been reported previously. NLR more than 1.62 was an independent predictor of OSA. A simple, cheap white blood cell count may also give an idea about the presence and severity of OSA (Tab. 3, Fig. 3, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: infl ammation, cardiovascular risk, neutrophil to lymphocyte ratio, obstructive sleep apnea.

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Usefulness of Neutrophil/Lymphocyte Ratio As Predictor of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting

Cited by 266 publications

References 21 publications

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

Use of neutrophil‐lymphocyte ratio for risk stratification and relationship with time in therapeutic range in patients with nonvalvular atrial fibrillation: A pilot study

The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

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