Correlation Between Neutrophil Lymphocyte Ratio And Atrial Fibrillation And Atrial Fibrillation Stroke

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Association of neutrophil lymphocyte ratio with atrial fibrillationObjectiveAt present,the status of inflammatory response in the occurrence and maintenance of atrial fibrillation(AF)has been widely recognized.The neutrophil lymphocyte ratio(NLR)has received attention as a new inflammatory marker.Foreign studies have confirmed that NLR levels and atrial fibrillation There is a correlation between the occurrence and maintenance of AF,but there is no in-depth study of its correlation with the Chinese.This study aims to study the correlation between the NLR level of the local population and the occurrence and development of atrial fibrillation,so as to provide the improvement of atrial fibrillation prevention technology and as a corresponding theoretical basis.MethodsIn this study,a case-control study method was used,and 145 patients with atrial fibrillation who were hospitalized in our hospital from January 2018 to December 2018 were selected as the experimental group,including 91 males and 54 females with an average age of 70.61±9.65 years.In addition,132 patients with non-atrial fibrillation matched with gender,age,and comorbidities were selected as the control group,including 88 males and 44 females,with an average age of 68.36±9.83 years.And recorded the clinical data of all selected patients,and compare whether there are statistical differences between the two groups.In addition,the patients in the experimental group were subdivided into paroxysmal atrial fibrillation group and chronic atrial fibrillation group according to the time of onset of atrial fibrillation,including 48 patients with paroxysmal atrial fibrillation and 97 patients with chronic atrial fibrillation.Compared whether the indicators between the two groups are statistically different.Results1.In gender,age,body mass index(BMI),hypertension,diabetes,heart failure,vascular disease,stroke/transient ischemic attack(TIA)history,platelets,blood creatinine(Cr),uric acid(UA),total Cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL)had no statistical difference between the atrial fibrillation group and the control group(P>0.05),and smoking history had significant statistics significance(P<0.05).The mean platelet volume(MPV),NLR level,and left atrial diameter(LAD)of the AF group were higher than those of the control group,while the left ventricular ejection fraction(LVEF)of the control group was higher than that of the AF group(P<0.05).The mean platelet volume(MPV)of the atrial fibrillation group and the control group were(10.839± 1.30)fl and(10.48± 1.29)fl,respectively,and the NLR was 3,33± 1.04 and 2.61 ± 0.99;the LAD was(37.81±7.54)mm and(34.10 ± 3.51)mm,LVEF was 65.13%± 7.69%and 67.29%± 5.20%,respectively.2.According to multivariate logistic regression analysis,the independent risk factors for atrial fibrillation are:increased MPV(OR,1.291,95%CI,1.046-1.594,P<0.05);increased LAD(OR,1.137,95%CI,1.067-1.212,P<0.05);smoking history(OR,3.650,95%CI,1.570-8.487,P<0.05);NLR increased(OR,2.080,95%CI,1.569-2.757,P<0.05).When NLR was changed to a multi-categorical variable according to quartiles and included in the prediction model,it was found that NLR at the highest quantile(OR,7.729,95%CI,3.440-17.365)had a significantly increased risk compared to the lowest quantile.3.The area under the ROC curve of LAD for predicting events of atrial fibrillation is 0.648(95%CI,0.581-0.714,P<0.05);the area under the curve of MPV is 0.578(95%CI,0.510-0.645,P<0.05);NLR The area under the curve is 0.701(95%CI,0.639-0.762,P<0.05),and the best diagnostic cutoff point for NLR is 2.63.The sensitivity and specificity at this time are 74.5%and 57.6%,respectively.Compared with the chronic atrial fibrillation group,the paroxysmal atrial fibrillation group was higher than the paroxysmal atrial fibrillation group in age,history of heart failure,blood creatinine,uric acid,triglyceride,and LAD(P<0.05)There was no statistical difference in NLR levels.ConclusionElevated NLR level is associated with the occurrence of atrial fibrillation,and increased NLR level may be an independent predictor of atrial fibrillation;NLR level has no significant correlation with the type of atrial fibrillationPart ? The Association between neutrophil lymphocyte ratio and Stroke in Patients with Atrial FibrillationObjectiveAF can significantly increase the incidence of stroke.This study aims to analyze the clinical data of patients with non-valvular atrial fibrillation to evaluate the association between NLR levels and stroke incidence in patients with atrial fibrillation,and included NLR in CHA2DS2-VASc scores to evaluate whether the new model can improve the prediction accuracy of atrial fibrillation strokeMethodsIn this study,579 patients with atrial fibrillation who were admitted to the Department of Cardiology of our hospital from January 2018 to December 2018 were selected as the research object,and they were grouped according to the NLR quartile.The ischemic stroke occurred during the 12-month period as the end point event,SPSS 23.0 was used for statistical analysis,and the lowest quantile NLR was used as the control group to compare the clinical data and follow-up resultsResults1.There was no significant difference in gender composition,history of diabetes,heart failure,and smoking history between the highest quartile NLR and the lowest quartile NLR(P>0.05),compared with the lowest quartile NLR patients,in the highest quartile of patients are older,and the prevalence of hypertension,vascular disease,and previous stroke/TIA comorbidities are higher(P<0.05).There were significant differences in neutrophil count,lymphocyte count,red blood cell distribution width,D dimer,low density lipoprotein,total cholesterol,triglyceride,NT-proBNP between the two groups(P<0.05),of which Low-density lipoprotein(LDL),total cholesterol(TC),and triglyceride(TG)decreased with the increase of NLR.2.During 1-year follow-up,a total of 32 patients experienced acute ischemic cerebral infarction.In the NLR quartile,the incidence of stroke increased in a dose-response manner:3.47 per 100 person-year,4.14,6.21 and 8.28.It can be found in the Kaplan-Meier survival curve that the cumulative incidence of stroke increases as the NLR quartile increases(log-rank test P=0.006,degrees of freedom:3).3.Cox regression analysis in adjusting the CHA2DS2-VASc score showed that NLR level was an independent risk factor for stroke.Compared with patients with the lowest NLR quartile,the risk of stroke increased with an increase in the NLR quartile;adjusted hazard ratios(HR)werel.383(95%CI,0.389-4.919)?2.534(95%CI,0.736-8.467)?5.565(1.299-13.256)(P<0.05).The HR was 2.641(95%CI,1.160-6.010,P<0.05)when NLR was used as a binary variable.NLR was used as a continuous variable.The HR was 1.157(95%CI,1.029-1.302),which independently predicted stroke.4.Using NLR as a binary classification variable and adding NLR>3.24 as a point to the CHA2DS2-VASc score,the predictive ability of the new model with NLR added was not significantly different from the old model(P>0.05).ConclusionNLR levels are associated with stroke risk in patients with AF and is an independent predictor;including high NLR levels in the CHA2DS2-VASc score did not significantly improve the accuracy of risk model predictions.