A Study Of The Correlation Between Preoperative NLR,PLR And New-onset Atrial Fibrillation After OPCABG

Background and ObjectivesAtrial fibrillation(AF)is the most common form of arrhythmias after coronary artery bypass grafting(CABG),which could result in disordered hemodynamics,decreased cardiac output,reduced myocardial blood supply and the following adverse events.Neutrophils are markers of non-specific inflammation in the human body and platelets can release inflammatory factors into the blood to promote inflammation.Lymphocytes play an important role in inflammation and oxidative stress as well.Numerous studies have shown that two newly recognized systemic inflammation response signals,serum neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR),have strong prospective effects of some cardiovascular diseases.We aim to identify the relationship between preoperative NLR,PLR and atrial fibrillation after elective off-pump coronary artery bypass grafting(OPCABG)via retrospective observation.Materials and Methods281 patients underwent OPCABG surgery between August 2016 and July 2017 at Shandong provincial hospital were selected continuously,according to the exclusion criteria,254 patients were enrolled in this study.They were performed retrospective observational study of preoperative NLR and PLR and their relevance to AF after OPCABG.According to preoperative NLR value,254 patients were divided into low-value group(preoperative NLR<1.72,n=84),median group(preoperative NLR1.72-2.39,n=85),high value group(preoperative NLR>2.39,n=85).According to preoperative PLR value,254 patients were divided into low-value group(preoperative PLR<118.3,n=84),median group(preoperative PLR118.3-143.6,n=85),high-value group(preoperative PLR>143.6,n=85).Patients were divided into AF group and control group as to case-control study design.General data,echocardiographic findings,intraoperative and postoperative conditions,and fasting cubital venous blood were collected on the morning of the second day of hospitalization to obtain relevant laboratory examination data.Data were analyzed by SPSS 17.0 software.The receiver operating characteristic curve(ROC curve)were applied to assess statistically significant factors.Results1.According to preoperative NLR values divided into low,medium and high three groups,three groups of age,history of myocardial infarction,postoperative ICU hospitalization days and total hospitalization days,AF,difference was statistically significant(P<0.05),there was no statistically significant difference the rest factors.The incidence rate of atrial fibrillation was 13.1%,21.2%and 31.8%,respectively.2.According to preoperative PLR values divided into low,medium and high three groups,three groups of age,c-reactive protein,postoperative ICU hospitalization days and total hospitalization days,AF,difference was statistically significant(P<0.05),there was no statistically significant difference the rest factors.The incidence rate of atrial fibrillation was 11.9%,20.0%and 34.1%,respectively.3.Compared with control group,the preoperative NLR,preoperative PLR,age,left atrial diameter,postoperative ICU length of stay,total length of hospital stay of AF group were of statistical significance(P<0.05).AF group had elevated preoperative NLR and preoperative PLR.4.Logistic multivariate regression analysis exhibited that preoperative NLR,preoperative PLR,age,left atrial diamete,were all independent risk factors of postoperative AF.Area under curve of ROC of preoperative NLR,preoperative PLR,age,left atrial diameter were 0.706,0.684,0.710 and 0.693 respectively,which were statistically significant.Thus the four factors above showed a predictive role in postoperative AF.The area under the ROC curve of preoperative NLR and preoperative PLR collaborative prediction was 0.793,higher than the single factor,indicating that the combined prediction effect was better.Conclusions1.Age,left atrial diameter,preoperative NLR,preoperative PLR are recognized as independent risk factors of postoperative AF and are of positive correlation with postoperative AF.2.Age,left atrial diameter,preoperative NLR,preoperative PLR could,to some extent,serve as predictors for postoperative AF.