Yeni Başlangıçlı Atriyal Fibrilasyon İçin Eozinofil/Lenfosit ve Eozinofil/Monosit Oranının Öngördürücü Değeri

Year 2025, Volume: 78 Issue: 4, 348 - 357, 31.12.2025

Mine Büşra Bozkürk , Veysel Ozan Tanık

https://doi.org/10.65092/autfm.1759334

Abstract

Amaç: Hematolojik indeksler, yeni başlangıçlı atriyal fibrilasyonun (YBAF) patogenezinde inflamasyonun önemli rolü nedeniyle sıklıkla araştırılan bir alandır. Çalışmamız ST segment elevasyonlu miyokard enfarktüsü (STEMI) hastalarında eozinofil-lenfosit oranı (ELR) ve eozinofil-monosit oranı (EMR) ile YBAF gelişiminin ilişkisini araştırmayı amaçlamıştır.
Gereç ve Yöntem: Bu retrospektif çalışmada, 344 STEMI hastası değerlendirildi ve YBAF gelişimine göre iki gruba ayrıldı (YBAF+: n=36, YBAF-: n=308). Hematolojik parametrelerin ve indekslerin ayırıcı gücü ve bağımsızlığı ROC analizi, lojistik regresyon ve temel bileşen analizi (TBA) kullanılarak değerlendirildi.
Bulgular: YBAF’lı hastalarda eozinofil sayıları ve EMR değerleri kontrol grubuna kıyasla anlamlı derecede düşük, ancak monosit sayıları daha yüksekti (tümü p<0,05). EMR ≤0,18, YBAF’ı %80 duyarlılık ve %64 özgüllükle öngördü (AUC: 0.682). Lojistik regresyon analizi, EMR’yi (OR=0,011, p=0,001) ve monosit sayısını (OR=27,67, p=0,012) YBAF’ın bağımsız öngörücüleri olarak ortaya koydu. TBA analizi, EMR ve monosit sayısını YBAF+ ve YBAFgruplarını ayıran ana değişkenler olarak doğruladı. ELR, YBAF+ grubunda daha düşük olmasına rağmen, çok değişkenli modellerde anlamlı bir fark bulunamadı.
Sonuç: EMR ve monosit sayısı, STEMI hastalarında yeni başlangıçlı atriyal fibrilasyonun bağımsız ve güçlü öngörücüleridir. Bu düşük maliyetli ve kolay erişilebilir belirteçlerin rutin klinik değerlendirmelere entegre edilmesi erken risk sınıflandırmasını iyileştirebilir ve aritmi izleme ve tedavisine rehberlik edebilir.

Keywords

STEMI , Atriyal fibrilasyon , Eozinofil/Monosit Oranı , Eozinofil/Lenfosit Oranı , Biyobelirteçler

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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