中性粒细胞与淋巴细胞比率是心房颤动患者不良事件的独立炎症生物标志物:穆尔西亚房颤项目 II (MAFP-II) 队列研究的启示

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Eva Soler-Espejo, Francisco Marín, Raquel López-Gálvez, María Pilar Ramos-Bratos, María Sánchez-Villalobos, María Asunción Esteve-Pastor, Gregory Y. H. Lip, José Miguel Rivera-Caravaca, Vanessa Roldán
{"title":"中性粒细胞与淋巴细胞比率是心房颤动患者不良事件的独立炎症生物标志物:穆尔西亚房颤项目 II (MAFP-II) 队列研究的启示","authors":"Eva Soler-Espejo,&nbsp;Francisco Marín,&nbsp;Raquel López-Gálvez,&nbsp;María Pilar Ramos-Bratos,&nbsp;María Sánchez-Villalobos,&nbsp;María Asunción Esteve-Pastor,&nbsp;Gregory Y. H. Lip,&nbsp;José Miguel Rivera-Caravaca,&nbsp;Vanessa Roldán","doi":"10.1002/clc.70102","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Systemic inflammation plays a central role in atrial fibrillation (AF). The neutrophil-to-lymphocyte ratio (NLR) is a simple hematological index that has been shown to be associated with prognosis in different pathologies.</p>\n </section>\n \n <section>\n \n <h3> Hypothesis</h3>\n \n <p>The NLR is associated with an increased risk of adverse events in patients with AF.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We included a prospective cohort of AF patients who started vitamin K antagonists (VKAs) therapy between July 2016 and June 2018. NLR was assessed at baseline and classified into three categories: low (&lt; 3), moderate (3–5), and high (&gt; 5). During a 2-year follow-up period, all cardiovascular deaths, all-cause deaths, and net clinical outcomes (NCO; either ischemic stroke/transient ischemic attack, major bleeding or all-cause death), were recorded.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 1050 patients were included (51.4% women; median age 77 years). NLR was available in 936 patients: 507 (54.2%) had low NLR (&lt; 3), 239 (25.5%) had moderate NLR (3–5), and 190 (20.3%) had high NLR (&gt; 5). The primary endpoint was significantly increased in the high NLR category (<i>p</i> = 0.002 for cardiovascular death; <i>p</i> &lt; 0.001 for all-cause mortality, and <i>p</i> &lt; 0.001 for NCO), with higher IRRs (all <i>p</i> &lt; 0.001). Multivariate Cox regression analyses showed that high NLR was independently associated with an increased risk of cardiovascular death (aHR: 2.02; 95% CI: 1.04–3.92), all-cause mortality (aHR: 2.51; 95% CI: 1.58–3.97), and NCO (aHR: 1.99; 95% CI: 1.37–2.87), compared to low NLR.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In this prospective AF cohort receiving VKAs, elevated NLR was significantly associated with an increased risk of adverse clinical outcomes. NLR has independent prognostic value beyond other classical risk factors.</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 2","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70102","citationCount":"0","resultStr":"{\"title\":\"The Neutrophil-to-Lymphocyte Ratio Is an Independent Inflammatory Biomarker for Adverse Events in Patients With Atrial Fibrillation: Insights From the Murcia AF Project II (MAFP-II) Cohort Study\",\"authors\":\"Eva Soler-Espejo,&nbsp;Francisco Marín,&nbsp;Raquel López-Gálvez,&nbsp;María Pilar Ramos-Bratos,&nbsp;María Sánchez-Villalobos,&nbsp;María Asunción Esteve-Pastor,&nbsp;Gregory Y. H. Lip,&nbsp;José Miguel Rivera-Caravaca,&nbsp;Vanessa Roldán\",\"doi\":\"10.1002/clc.70102\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Systemic inflammation plays a central role in atrial fibrillation (AF). The neutrophil-to-lymphocyte ratio (NLR) is a simple hematological index that has been shown to be associated with prognosis in different pathologies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Hypothesis</h3>\\n \\n <p>The NLR is associated with an increased risk of adverse events in patients with AF.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We included a prospective cohort of AF patients who started vitamin K antagonists (VKAs) therapy between July 2016 and June 2018. NLR was assessed at baseline and classified into three categories: low (&lt; 3), moderate (3–5), and high (&gt; 5). During a 2-year follow-up period, all cardiovascular deaths, all-cause deaths, and net clinical outcomes (NCO; either ischemic stroke/transient ischemic attack, major bleeding or all-cause death), were recorded.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 1050 patients were included (51.4% women; median age 77 years). NLR was available in 936 patients: 507 (54.2%) had low NLR (&lt; 3), 239 (25.5%) had moderate NLR (3–5), and 190 (20.3%) had high NLR (&gt; 5). The primary endpoint was significantly increased in the high NLR category (<i>p</i> = 0.002 for cardiovascular death; <i>p</i> &lt; 0.001 for all-cause mortality, and <i>p</i> &lt; 0.001 for NCO), with higher IRRs (all <i>p</i> &lt; 0.001). Multivariate Cox regression analyses showed that high NLR was independently associated with an increased risk of cardiovascular death (aHR: 2.02; 95% CI: 1.04–3.92), all-cause mortality (aHR: 2.51; 95% CI: 1.58–3.97), and NCO (aHR: 1.99; 95% CI: 1.37–2.87), compared to low NLR.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>In this prospective AF cohort receiving VKAs, elevated NLR was significantly associated with an increased risk of adverse clinical outcomes. NLR has independent prognostic value beyond other classical risk factors.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10201,\"journal\":{\"name\":\"Clinical Cardiology\",\"volume\":\"48 2\",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-02-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70102\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/clc.70102\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Cardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/clc.70102","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

背景:全身性炎症在心房颤动(AF)中起核心作用。中性粒细胞与淋巴细胞比率(NLR)是一种简单的血液学指标,已被证明与不同病理的预后相关。假设NLR与房颤患者不良事件风险增加相关。方法我们纳入了一组在2016年7月至2018年6月期间开始服用维生素K拮抗剂(VKAs)治疗的房颤患者的前瞻性队列。NLR在基线时进行评估,并分为三类:低(< 3)、中(3 - 5)和高(> 5)。在2年随访期间,所有心血管死亡、全因死亡和净临床结果(NCO;记录缺血性中风/短暂性缺血性发作、大出血或全因死亡。结果共纳入1050例患者,其中女性51.4%;中位年龄77岁)。936例患者有NLR: 507例(54.2%)为低NLR (< 3), 239例(25.5%)为中度NLR(3 - 5), 190例(20.3%)为高NLR (> 5)。高NLR组的主要终点显著增加(心血管死亡p = 0.002;全因死亡率p <; 0.001, NCO p < 0.001), irr较高(均p <; 0.001)。多因素Cox回归分析显示,高NLR与心血管死亡风险增加独立相关(aHR: 2.02;95% CI: 1.04-3.92),全因死亡率(aHR: 2.51;95% CI: 1.58-3.97)和NCO (aHR: 1.99;95% CI: 1.37-2.87),与低NLR相比。在接受vka的前瞻性房颤队列中,NLR升高与不良临床结果的风险增加显著相关。NLR比其他经典危险因素具有独立的预后价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Neutrophil-to-Lymphocyte Ratio Is an Independent Inflammatory Biomarker for Adverse Events in Patients With Atrial Fibrillation: Insights From the Murcia AF Project II (MAFP-II) Cohort Study

The Neutrophil-to-Lymphocyte Ratio Is an Independent Inflammatory Biomarker for Adverse Events in Patients With Atrial Fibrillation: Insights From the Murcia AF Project II (MAFP-II) Cohort Study

Background

Systemic inflammation plays a central role in atrial fibrillation (AF). The neutrophil-to-lymphocyte ratio (NLR) is a simple hematological index that has been shown to be associated with prognosis in different pathologies.

Hypothesis

The NLR is associated with an increased risk of adverse events in patients with AF.

Methods

We included a prospective cohort of AF patients who started vitamin K antagonists (VKAs) therapy between July 2016 and June 2018. NLR was assessed at baseline and classified into three categories: low (< 3), moderate (3–5), and high (> 5). During a 2-year follow-up period, all cardiovascular deaths, all-cause deaths, and net clinical outcomes (NCO; either ischemic stroke/transient ischemic attack, major bleeding or all-cause death), were recorded.

Results

A total of 1050 patients were included (51.4% women; median age 77 years). NLR was available in 936 patients: 507 (54.2%) had low NLR (< 3), 239 (25.5%) had moderate NLR (3–5), and 190 (20.3%) had high NLR (> 5). The primary endpoint was significantly increased in the high NLR category (p = 0.002 for cardiovascular death; p < 0.001 for all-cause mortality, and p < 0.001 for NCO), with higher IRRs (all p < 0.001). Multivariate Cox regression analyses showed that high NLR was independently associated with an increased risk of cardiovascular death (aHR: 2.02; 95% CI: 1.04–3.92), all-cause mortality (aHR: 2.51; 95% CI: 1.58–3.97), and NCO (aHR: 1.99; 95% CI: 1.37–2.87), compared to low NLR.

Conclusions

In this prospective AF cohort receiving VKAs, elevated NLR was significantly associated with an increased risk of adverse clinical outcomes. NLR has independent prognostic value beyond other classical risk factors.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信