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

Year 2019, Volume: 10 Issue: 3, 278 - 283, 20.09.2019

Hasan Aydın Baş Ali Bağcı Fatih Aksoy

https://doi.org/10.22312/sdusbed.543444

Cited By: 3

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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