ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 October;178(10):736-40

DOI: 10.23736/S0393-3660.18.03842-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Association of neutrophil lymphocyte ratio and C-reactive protein with left atrial appendage thrombus: a transesophageal echocardiography study

Murat BAYRAK ¹, Veysel TOSUN ² ✉, Ali Y. KILINÇ ³, Gündüzalp SAYDAM ³, Necmettin KORUCUK ⁴, Refik E. ALTEKİN ³, Hüseyin YILMAZ ³

¹ Department of Cardiology, Silopi State Hospital, Şırnak, Turkey; ² Department of Cardiology, Şanlıurfa Education and Research Hospital, Şanlıurfa, Turkey; ³ Department of Cardiology, Akdeniz University Faculty of Medicine, Antalya, Turkey; ⁴ Department of Cardiology, Private Medical Park Hospital, Antalya, Turkey

BACKGROUND: There is no clear study showing that neutrophil lymphocyte ratio (NLR) and C-reactive protein (CRP) are investigated only with left atrial (LA) or left atrial appendage thrombus (LAAT). The aim of this study is to investigate the association between NLR, CRP and LA or LAAT.
METHODS: A total of 461 non-valvular atrial fibrillation patients with their demographic, clinic and laboratory parameters were enrolled in the study. All patients were evaluated by transesophageal echocardiography (TEE) before direct current cardioversion (DCCV) and cryoablation therapy for thrombus in the LA and LAA. Dense echogenic masses sticking to LA or LAA wall, moving independently from the LAA wall was accepted as LA/LAA thrombus.
RESULTS: LAT/LAAT(+) group consisted of 172 (37%) patients, LAT/LAAT(-) group consisted of 289 (63%) patients. Percentage of patients with CHA2DS2-VASc≥3 was significantly higher in LAT/LAAT(+) group compare with LAT/LAAT(-) group (89 [51.7%] vs. 117 [40.5%], P<0.001). The CRP and NLR were higher in LAT/LAAT(+) group than in LAT/LAAT(-) group but these differences were not significant (1.45 [0.35-1.2] vs. 1.22 [0.29-1.2], P=0.285 and 3.3 [1.73-3.5] vs. 3.1 [1.75-3.8], P=0.506, respectively). Also, there was no any significant difference between high CRP value and LAT/LAAT(+) group by Chi-square test.
CONCLUSIONS: We advocate that our study will highlight the complex results of other studies on CRP, RDW, NLR with LAT/LAAT, and will show the necessity of further studies investigating the relationship between these parameters and non-valvular AF.

KEY WORDS: Neutrophils; Lymphocytes; C-reactive protein; Atrial appendage; Thrombosis