Predictive Value of Eosinophil/Lymphocyte and Eosinophil/Monocyte Ratio for New-Onset Atrial Fibrillation
Abstract
Objectives: Hematological indices are a frequently investigated area due to the important role of inflammation in the pathogenesis of new-onset atrial fibrillation (NOAF). Our study aimed to investigate the relationship between eosinophil-to-lymphocyte ratio (ELR) and eosinophil-to-monocyte ratio (EMR) and the development of NOAF in patients with ST-segment elevation myocardial infarction (STEMI).
Materials and Methods: In this retrospective study, 344 STEMI patients were evaluated and divided into two groups based on the development of NOAF (NOAF+: n=36, NOAF-: n=308). The discriminatory power and independence of hematological parameters and indices were evaluated using ROC analysis, logistic regression, and principal component analysis (PCA).
Results: Patients with NOAF had significantly lower eosinophil counts and EMR values compared to the control group, but higher monocyte counts (all p<0.05). EMR ≤0.18 predicted NOAF with 80% sensitivity and 64% specificity (AUC: 0.682). Logistic regression analysis revealed EMR (OR=0.011, p=0.001) and monocyte count (OR=27.67, p=0.012) as independent predictors of NOAF. PCA analysis confirmed EMR and monocyte count as the main variables distinguishing the NOAF+ and NOAF− groups. Although ELR was lower in the NOAF+ group, no significant differences were found in the multivariate models.
Conclusion: EMR and monocyte count are independent and strong predictors of NOAF in STEMI patients. Integrating these low-cost and easily accessible markers into routine clinical assessments can improve early risk stratification and guide arrhythmia monitoring and treatment.
Keywords
STEMI, Atrial Fibrillation, Eosinophil/Monocyte Ratio, Eosinophil/Lymphocyte Ratio, Biomarkers
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