Usefulness of Mean Platelet Volume and Neutrophil-To-Lymphocyte Ratio for Development of Atrial Fibrillation After Acute Myocardial Infarction

Abstract

Amaç: Atriyal fibrilasyon (AF), ST yükselmiş miyokard infarktüsünü (STEMI) takiben en sık görülen supraventriküler aritmidir. Ortalama trombosit hacmi (MPV) trombosit aktivasyonunun ve fonksiyonunun bir göstergesidir. Ortalama trombosit hacmi, gelecekteki inme ve miyokard enfarktüsü için bağımsız bir risk faktörü olarak belirlenmiştir. Nötrofil / lenfosit oranı (NLR) tespiti, inflamatuar durumu değerlendirmek için hızlı ve basit bir yöntem olup son zamanlarda kardiyovasküler risk ve AF için bir ön gördürücü olarak saptanmıştır.  Bu çalışmanın amacı, STEMI sonrası AF gelişiminde NLR ve MPV düzeyleri arasındaki olası bir ilişkiyi değerlendirmektir.

Yöntem: Bu prospektif çalışmaya, koroner bakım ünitesine başvuran, akut STEMI' li 743 hasta dahil edildi. Hastalar AF olan ve olmayan iki gruba ayrıldı. AF gelişimin ön gördürücüleri çok değişkenli regresyon analizi ile belirlendi.

Bulgular: STEMI ile başvuran toplam 743 hastanın 82 sinde (%11) AF gelişti. Ortalama trombosit hacmi ve NLR, AF' gelişen hastalarda AF gelişmeyen hastalara göre anlamlı derecede yüksekti (sırasıyla p <0,001). Çok değişkenli regresyon analizi sonuçları, yaş [Odds ratio (OR)=1,03; %95 Güven Aralığı (GA)=1,01-1,05; p=0,001), ejeksiyon fraksiyonu (OR=0,95; %95 GA = 0,93-0,98; p <0,001), MPV (OR=1,738; % 95 GA = 1,29-2,33; p<0,001), NLR (OR=1,08; %95, GA=1,01-1,15; p=0,025) ve hastane öncesi anjiyotensinojen dönüştürücü enzim blokerleri kullanımı (OR=3.04; % 95 GA=1,22-7,54; p = 0,017), STEMI hastalarında AF gelişimi ile ilişkiliydi.

Sonuç: Bu çalışma, MPV ve NLR' nin STEMI hastalarda AF gelişimi ile ilişkili olduğunu ve AF' nin diğer bağımsız ön gördürücülerinin ise yaş ve ejeksiyon fraksiyonunu olduğunu göstermiştir.

Keywords

• Miyokard infarktüsü,atriyal fibrilasyon,ortalama trombosit hacmi,nötrofil lenfosit oranı

Usefulness of mean platelet volume and neutrophil-to-lymphocyte ratio for development of atrial fibrillation after acute myocardial infarction

Abstract

Objective: Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST elevated myocardial infarction (STEMI). Mean platelet volume (MPV) is an indicator of platelet activation and function. Mean platelet volume has been identified as an independent risk factor for future stroke and myocardial infarction. The neutrophil-to-lymphocyte ratio (NLR), fast and easy method for detecting inflammatory status, have been recently explored as a predictor for cardiovascular risk and AF. The aim of the present study was to evaluate a possible relationship between NLR and MPV levels on development of AF after STEMI.

Methods: This prospective study consisted of 743 patients with acute STEMI who were admitted to coronary care unit. Patients were divided into two groups, patients with and without AF. Predictors of AF were determined by multivariate regression analysis.

Results: From a total of 743 patients presenting with STEMI, 82 (11%) developed AF. Mean platelet volume and NLR was significantly higher in patients with AF compared to without AF (p<0.001, respectively). Multivariate regression analysis results showed that, age [Odds Ratio (OR)=1.03; 95% Confidence Interval (CI)=1.01-1.05; p=0.001), ejection fraction (OR=0.95; 95% CI=0.93-0.98; p<0,001), MPV (OR=1.738; 95% CI=1.29-2.33; p<0.001), NLR (OR=1.08; 95% CI=1.01-1.15; p=0,025) and previous angiotensinogen converting enzyme blockers (OR=3.04; 95% CI=1.22-7.54; p=0,017) using were associated with development of AF in patients with acute STEMI.

Conclusions: This study showed that, MPV and NLR were associated with the development of AF in patients presenting STEMI, other independent predictors of AF included age, and ejection fraction.

Keywords

• Myocardial infarction,atrial fibrillation,mean platelet volume,neutrophil-to-lymphocyte ratio

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