Changes Of Inflammatory Markers CAR And NLR In Peripheral Blood Of Patients With Coronary Heart Disease Complicated With Atrial Fibrillation

Objective:To observe the levels of C-reactive protein/albumin ratio(CAR)and neutrophil count/lymphocyte count(NLR)in peripheral blood of patients with coronary heart disease complicated with new-onset atrial fibrillation,and to explore the correlation and clinical significance of CAR,NLR and new-onset atrial fibrillation in patients with coronary heart disease,so as to provide basis for early identification of new-onset atrial fibrillation in patients with coronary heart disease.Methods:This study Collect Patients Age,sex,BMI,weight,height,past history,neutrophil count(N),lymphocyte count(L),red blood cell(RBC),white blood cell(WBC),C-reactive protein(CRP),albumin(Alb),creatinine(Cr),aspartate transferase(AST),serum potassium(K)were collected.C-reactive protein/albumin ratio(CAR),neutrophil count/lymphocyte count ratio(NLR),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWT),interventricular septum thickness(IVST),left ventricular ejection fraction(LVEF)and Gensini score were calculated.The levels of CAR and NLR were compared among the four groups,and Logistic regression analysis was used to identify the risk factors of coronary heart disease complicated with new atrial fibrillation.ROC analysis was performed to distinguish its predictive value for coronary heart disease complicated with new-onset atrial fibrillation.Results:In univariate analysis,smoking,hypertension,age,BMI,diabetes,N,L,WBC,AST,Alb,CRP,NLR,CAR,Cr,LAD,IVST,LVPWT,LVEDD,LVEF,angiographic results and Gensini scores were significantly different among the four groups.(P<0.05),There was no significant difference in other indexes among the four groups.(P>0.05).Comparing the changes of CAR and NLR among the four groups,it was found that the levels of NLR and CAR in coronary heart disease complicated with new-onset atrial fibrillation group were significantly higher than those in atrial fibrillation group,coronary heart disease group and control group.(P>0.05),Logistic regression model analysis showed that:(1)Age,hypertension,NLR,CAR,LAD were statistically significant between atrial fibrillation group and normal group(P<0.05),these are the independent risk factors of atrial fibrillation(OR>1).(2)In CHD and normal group,smoking,diabetes,NLR,LVEDD and LVEF were significantly different between the two groups(P<0.05).Smoking,diabetes,NLR and LVEDD were the independent risk factors of CHD(OR>1),and LVEF was the protective factor of CHD(OR=0.914).(3)There were significant differences in hypertention,CAR,AST,LVEDD,LVEF and Gensini scores between CHD group and new-onset atrial fibrillation complicated with CHD group(P<0.05).Hypertension,CAR,AST,LVEDD and high Gensinis score were the risk factors of new-onset atrial fibrillation in CHD patients(OR>1),and LVEF was the protective factor of AF in CHD patients(OR=0.949).(4)In ROC analysis,the AUC value of CAR and NLR is between0.7～0.9,either have the stastical significant(P<0.05).The AUC value of CAR is higher than NLP have the stastical significant(χ~2=21.94,P<0.001),CAR predicted cutoff value≥0.072,specificity 82.7%,sensitivity 88.1%,positive predictive value 77.4%,negative predictive value 91.2%.Conclusion:1.The levels of CAR and NLR in the group of CHD with atrial fibrillation were the highest.2.Hypertension,CAR,AST,LVEDD and Gensini scores are the risk factors of new-onset atrial fibrillation in patients with coronary heart disease,and high LVEF is the protective factor of new-onset atrial fibrillation in patients with coronary heart disease.