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SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1461923

Predictive value of neutrophil to lymphocyte ratio for clinical outcome in patients with atrial fibrillation: a systematic review and metaanalysis

Provisionally accepted
Lei Peng Lei Peng 1Li Liu Li Liu 2Miaomiao Chai Miaomiao Chai 1Zhonggui Cai Zhonggui Cai 3Deqi Wang Deqi Wang 4*
  • 1 Linping Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China
  • 2 Jinan Integrated Traditional Chinese and Western Medicine Hospital, Jinan, China
  • 3 Shandong Healthcare Group Zao zhuang Hospital, Zaozhuang, China
  • 4 Zaozhuang Municipal Hospital, Zaozhuang, China

The final, formatted version of the article will be published soon.

    The association between the Neutrophil-to-Lymphocyte Ratio (NLR) and the prognosis of Atrial Fibrillation (AF) has been extensively studied, yet clinical outcomes have varied.Consequently, this analysis was undertaken to explore the link between NLR and the prognostic markers of AF.We conducted an exhaustive search across electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, to investigate the correlation between the NLR and indicators of adverse clinical outcomes associated with AF from the database establishment date through March 31, 2024. In this study, the recurrence rate of AF was the primary outcome measure, while the secondary outcome measures were mortality, stroke, and left atrial thrombus. Odds ratio (OR), relative risk (RR), hazard ratio (HR) and standard mean difference (SMD) with a 95% confidence interval (CI) were integrated for assessment, and the stability of prognostic outcomes and publication bias were verified by sensitivity analysis and Egger's test, respectively. Subgroup analyses were performed to pinpoint the sources of heterogeneity.Results: This analysis included 20 studies, encompassing a total of 59,256 patients. Our statistical analysis of both categorical and continuous variables revealed that an elevated NLR was significantly associated with increased risks in AF patients for recurrence (categorical variable: OR = 1.39, 95% CI = 1.21-1.60; continuous variable: SMD = 0.49, 95% CI = 0.24-0.74), mortality (categorical variable: OR = 1.87, 95% CI = 1.59-2.20), stroke (categorical variable: OR = 1.56, 95% CI = 1.13-2.17; continuous variable: SMD = 0.77, 95% CI = 0.63-0.91), and left atrial thrombus (categorical variable: OR = 1.87, 95% CI = 1.27-2.75; continuous variable: SMD = 0.59, 95% CI = 0.30-0.89).Subgroup analyses found that high NLR was significantly linked to AF recurrence when the NLR was > 3. High NLR was significantly linked to the risk of stroke in AF when the NLR was ≤ 3.This study suggested that a high NLR is significantly linked to prognostic risk markers of AF, and NLR may be an effective biomarker for the prognosis of AF in clinical practice.

    Keywords: Neutrophil-to-lymphocyte ratio, Atrial Fibrillation, prognosis, Systematic review, Meta-analysis

    Received: 09 Jul 2024; Accepted: 16 Sep 2024.

    Copyright: © 2024 Peng, Liu, Chai, Cai and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Deqi Wang, Zaozhuang Municipal Hospital, Zaozhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.