title: Can neutrophil/lymphocyte ratio predict recurrence of non-valvular atrial fibrillation after cardioversion?
abstract: OBJECTIVE
  High neutrophil/lymphocyte ratio (NLR) has been associated with post-operative AF development in patients who underwent cardiac surgery. In this study, effectiveness of NLR for prediction of recurrence after electrical cardioversion (CV) in non-valvular AF was investigated.
  
  
  METHODS
  A total of 149 patients who underwent a successful CV were included in this prospective cohort study. Baseline complete blood cell count, routine biochemical tests, high sensitive C-reactive protein (hs-CRP), and echocardiographic measurements were examined. After CV, patients were monitored over six months for recurrence. Baseline characteristics of recurrence group were compared with sinus rhythm group by using Student`s t -test. Logistic regression analysis was used to determine predictors of recurrence.
  
  
  RESULTS
  Recurrence occurred in a total of 46 patients (30.9%). Median AF duration [16 (IQR:14.25) vs. 12 (IQR:11) months, p=0.01], baseline hs-CRP [9.80 (IQR: 8.50) mg/dL vs. 4.28 (IQR: 5.65) mg/dL, p=0.002] and left atrium (LA) diameter (4.5±0.4 cm, 4.3±0.5 cm, p=0.023) were significantly higher in the recurrence group than sinus rhythm group. Median NLR was comparable in recurrence and sinus groups [2.38 (IQR: 2.09) vs. 2.23, (IQR: 1.23) p=0.96, respectively]. There was a weak correlation between NLR and hs-CRP (r=0.22, p=0.05) and age (r=0.24, p=0.02). In multiple logistic regression analysis, hs-CRP [OR: 1.34 (1.09-1.65 95% CI) p=0.006], LA diameter [OR: 11.92 (1.84-77.07 95% CI) p=0.01], spontaneous echo contrast positivity, [OR: 5.40 (1.04-12.02 95% CI) p=0.045] and systolic blood pressure [OR: 1.05 (1.01-1.10 95% CI) p=0.03] were independent predictors of AF recurrence.
  
  
  CONCLUSIONS
  NLR failed to predict AF recurrence after a successful electrical CV, but hs-CRP remained an inflammatory marker of AF recurrence.
authors.affiliation: Department of Cardiology, Faculty of Meram Medicine, Necmettin Erbakan University, Konya-Turkey. draribas@hotmail.com
authors.forename: Alpay
authors.initials: A
authors.lastname: Arıbaş
authors.forename: Hakan
authors.initials: H
authors.lastname: Akıllı
authors.forename: Enes Elvin
authors.initials: EE
authors.lastname: Gül
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kayrak
authors.forename: Kenan
authors.initials: K
authors.lastname: Demir
authors.forename: Cetin
authors.initials: C
authors.lastname: Duman
authors.forename: Hajrudin
authors.initials: H
authors.lastname: Alibasiç
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazıcı
authors.forename: Kurtuluş
authors.initials: K
authors.lastname: Ozdemir
authors.forename: Hasan
authors.initials: H
authors.lastname: Gök
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood / Q000628:therapy*; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis
chemical_list: D015415:Biomarkers