Predictive value of neutrophil-lymphocyte ratio in recurrence of atrial fibrillation after radiofrequency ablation

Wang Tao; Wang Zhen; Zhao Ye; Hui Jie.

doi:10.3969/j.issn.1674-4055.2019.03.25

Abstract：Objective To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) for postoperative recurrence of atrial fibrillation (AF) radiofrequency ablation (RFCA). Methods In this study, 129 patients with AF who were admitted to the First Affiliated Hospital of Soochow University from January 01, 2014 to December 31, 2015 were enrolled. Cox multivariate regression analysis was used to adjust the risk factors affecting recurrence after RFCA, and the NLR pair was evaluated. The effect of recurrence after AF, and the receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of NLR for postoperative recurrence. Results After an average of 15 months of follow-up, a total of 40 patients (31.0%) relapsed, including 25 patients with recurrent paroxysmal atrial fibrillation (24.8%) and 15 patients with persistent atrial fibrillation (53.6%). The difference was statistically significant (P=0.004). Grouped by quartiles of NLR, the recurrence rates from low to high were 5 (15.6%), 8 (24.2%), 9 (28.1%), and 18 (56.3%), respectively, and there was a significant difference (P=0.003). Multivariate Cox regression analysis showed that women, left atrial diameter (LAD), persistent atrial fibrillation, and NLR were independent risk factors for postoperative recurrence of atrial fibrillation (P <0.05), and NLR was included in Cox regression analysis with quartile It was further confirmed that high levels of NLR increased the likelihood of postoperative recurrence (HR=3.917, 95% CI: 1.363~11.257, P=0.011). The ROC curve was used to estimate the predictive value of NLR for postoperative recurrence of AF. The AUC of all AF patients was 0.701 (95%CI: 0.597~0.805, P<0.001), and the AUC of patients with paroxysmal atrial fibrillation was 0.675 (95%CI: 0.543~0.806, P=0.009), AUC was 0.80 (95%CI: 0.625-0.975, P=0.007) in patients with persistent atrial fibrillation. Conclusion High-level NLR is associated with recurrence after radiofrequency ablation of atrial fibrillation and is an independent risk factor for postoperative recurrence.