The Predictive Value Of Preoperative PLR,NLR And NT-pro BNP For Recurrence Of Atrial Fibrillation After Radiofrequency Ablation

BackgroundRecurrence of atrial fibrillation(AF)after radiofrequency ablation is associated with a variety of factors,and studies have shown that recurrence of AF is associated with inflammation and left heart function.Platelet-to-lymphocyte ratio(PLR),Neutrophil-tolymphocyte ratio(NLR),and N-terminal B-type natriuretic peptide(NT-pro BNP)are associated with the development and progression of cardiovascular disease.The purpose of this study was to assess the predictive value of PLR,NLR,and NT-pro BNP for recurrence of AF after radiofrequency ablation.Subjects and MethodsIn this study,392 patients with AF who were 18 years of age or older who were medically ineffective or unable to tolerate medication,including 215 with paroxysmal atrial fibrillation(PaAF)and 177 with persistent atrial fibrillation(PeAF),were selected for first catheter radiofrequency ablation.Patients with previous radiofrequency ablation,cardiac ultrasound suggesting left ventricular ejection fraction<50%,left atrial internal diameter>55 mm,acute infectious disease,and hyperthyroidism were excluded.Blood count,NT-pro BNP,and transthoracic echocardiographic parameters were retrospectively analyzed in all patients.All patients were divided into recurrent and non-recurrent groups.Univariate and multivariate Cox analyses and correlation analysis were used to analyze the risk factors affecting the recurrence ofA F after radiofrequency ablation.Receiver operating characteristic(ROC)curves were constructed to assess the predictive performance and optimal cut of levels of the variables.The probability of recurrence after AF ablation was assessed according to the cut-off value.ResultsThe mean follow-up was 21(10-34)months,of which 73 cases relapsed(22.88%).PLR and Right atrial diameter(RAD)were significantly higher in the recurrence group than in the non-recurrence group(P<0.05).The multifactorial Cox regression analysis showed that in AF,PLR and RAD were different between the two groups(P<0.05),and there was no correlation between PLR and RAD.Patients with AF were divided into two groups by PLR=104.64 and a curve analysis of the probability of recurrence was performed.Log-Rank test showed that P<0.001.In PaAF,there were 215 cases,of which 34 were recurrences(15.81%).PLR,right ventricular diameter(RVD)and RAD were significantly higher in the recurrence group(P<0.05).The multifactorial Cox regression analysis showed that PLR and RVD differed between the two groups(P<0.05),and there was no correlation between them.Patients with PaAF were divided into two groups by PLR=104.64 and a curve analysis of the probability of recurrence was performed.LogRank test showed that P=0.003.In PeAF,there were 177 cases,of which 39 recurred(22.03%).PLR and left atrial diameter(LAD)were higher in the recurrence group(P<0.05).The multifactorial Cox regression analysis showed that PLR and LAD were statistically different between the two groups(P<0.05)and there was no correlation.Patients with AF were divided into two groups by PLR=104.54 and a curve analysis of the probability of recurrence was performed.Log-Rank test showed that P=0.001.Univariate and multivariate analyses in patients with preoperative C-reactive protein(CRP)testing showed a statistically significant difference in PLR between the two groups(p<0.001),while there was no statistical difference in CRP between the two groups(p=0.934).In combined prediction:the area under the curve(AUC)and sensitivity of PLR combined with NLR in Pa AF to predict postoperative recurrence was improved.Conclusion:High preoperative PLR predicts recurrence of AF after radiofrequency ablation,and more sensitive than CRP;PLR combined with NLR may improve predictive efficiency after AF ablation.