title: Neutrophil to lymphocyte ratio is predictor of atrial fibrillation recurrence after cardioversion with amiodarone.
abstract: BACKGROUND
  In this study, our aim is to examine the role of the neutrophil to lymphocyte ratio (NLR) in the predictions of recurrence under long-term follow-up in patients whose sinus rhythms (SRs) were restored with amiodarone in acute atrial fibrillation (AF).
  
  
  METHODS
  Retrospectively, patients with acute AF, which successfully converted to the SR with amiodarone treatment, were recruited into the study. Patients experiencing the first AF attack were enrolled to the study and followed up for 5 years (median 23 months, 25-75 percentiles 12-24 months). Neutrophil to lymphocyte ratio was computed as absolute neutrophil count divided by lymphocyte count.
  
  
  RESULTS
  A total of 218 patients were recruited into the study and followed up for 21.6 ± 13.9 months; 87 (40%) patients had ≥1 recurrent AF attack within this period. The follow-up of 131 (60%) patients resulted in persisted SR without any other AF attack. Groups were similar in terms of age and gender. Left atrium (LA) diameter and NLR were increased, and platelet count and lymphocyte count were decreased in patients with AF recurrence in univariate analysis (P < .05 for all). Only LA diameter (for per mm, 1.077 [1.021-1.136], P = .006) and NLR (1.584 [1.197-2.095], P = .001) were independent predictors of AF recurrence in the multivariate analysis.
  
  
  CONCLUSIONS
  Increased NLR is a marker of increased inflammation and may serve as simple, cheap, and readily available predictors of recurrence in the long-term follow-up of patients admitted with acute AF and successfully converted to SR with amiodarone.
authors.affiliation: Department of Cardiology, Çorum Training and Research Hospital, Hitit University, Çorum, Turkey drcomtr@gmail.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Karavelioğlu
authors.affiliation: Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
authors.forename: Hekim
authors.initials: H
authors.lastname: Karapınar
authors.affiliation: Department of Cardiology, Dicle University Medical School, Diyarbakır, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yüksel
authors.affiliation: Department of Cardiology, Çorum Training and Research Hospital, Hitit University, Çorum, Turkey.
authors.forename: Kadriye
authors.initials: K
authors.lastname: Memiç
authors.affiliation: Department of Cardiology, Çorum Training and Research Hospital, Hitit University, Çorum, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Sarak
authors.affiliation: Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Kurt
authors.affiliation: Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yilmaz
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood* / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D016015:Logistic Models; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000889:Anti-Arrhythmia Agents; D018836:Inflammation Mediators; D002097:C-Reactive Protein; D000638:Amiodarone
keywords: amiodarone; atrial fibrillation; cardioversion; neutrophil to lymphocyte ratio