Neutrophil-lymphocyte ratio may predict left atrial thrombus in patients with nonvalvular atrial fibrillation.
OBJECTIVE
Neutrophil-lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular diseases. We aimed to compare NLRs among patients with nonvalvular atrial fibrillation (AF) with or without left atrial (LA) thrombus.


METHODS
A total of 309 (70.1 ± 9.8 years, 49% male) patients with nonvalvular AF have undergone transoesophageal echocardiography (TEE) to assess the presence of LA thrombus. Baseline NLR was measured by dividing neutrophil count to lymphocyte count.


RESULTS
Left atrial thrombus was detected in 32 (10.3%) of 309 patients. Mean NLR (2.2 ± 1.0 vs 2.7 ± 1.1, P = .026) was significantly higher among patients with LA thrombus compared to patients without LA thrombus. On multivariate analysis, NLR (odds ratio 1.59, 95% confidence interval 0.87-4.18; P < .02) was an independent risk factor for the presence of LA thrombus in patients with nonvalvular AF.


CONCLUSIONS
Neutrophil-lymphocyte ratio, an emerging marker of inflammation, was independently associated with the presence of LA thrombus in patients with nonvalvular AF.
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Murat
M
Yalcin
Department of Cardiology, Etimesgut Military Hospital, Ankara, Turkey.
Mustafa
M
Aparci
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Omer
O
Uz
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Zafer
Z
Isilak
Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey drsevketb@gmail.com.
Sevket
S
Balta
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Mehmet
M
Dogan
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Ejder
E
Kardesoglu
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Mehmet
M
Uzun
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology
D015415:Biomarkers
atrial fibrillation; inflammation; left atrial thrombus; neutrophil–lymphocyte ratio