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Preoperative Platelet-to-Lymphocyte Ratio Is Not Associated With Postoperative Atrial Fibrillation
Rohan V Navani1, Arul Baradi2, Kuo Lin Colin Huang1
1Melbourne Medical School, The University of Melbourne, Melbourne, Australia; Department of Cardiology, St Vincent's Hospital, Melbourne, Australia.
Insights
Elevated preoperative platelet-to-lymphocyte ratio (PLR) does not predict postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG). This study found no independent association between high PLR and POAF incidence in CABG patients.
Area of Science:
- Cardiology
- Inflammation Biomarkers
- Surgical Complications
Background:
- Postoperative atrial fibrillation (POAF) is a frequent complication following coronary artery bypass grafting (CABG).
- Inflammation is implicated in POAF pathogenesis, prompting investigation into inflammatory biomarkers.
- The platelet-to-lymphocyte ratio (PLR) is a novel, accessible inflammatory marker with potential predictive value.
Purpose of the Study:
- To investigate the association between preoperative platelet-to-lymphocyte ratio (PLR) and the incidence of postoperative atrial fibrillation (POAF) in patients undergoing isolated coronary artery bypass grafting (CABG).
Main Methods:
- A cohort of 1457 patients undergoing isolated CABG without prior arrhythmia history was analyzed.
- Patients were stratified into low (<86) and high (≥86) preoperative PLR groups based on ROC analysis.
- POAF incidence was compared between groups, with logistic regression used for multivariable analysis.
Main Results:
- The overall incidence of POAF was 34.0% (495/1457 patients).
- No significant difference in POAF incidence was observed between the high-PLR (34.8%) and low-PLR (31.0%) groups (P = .22).
- High preoperative PLR was not independently associated with POAF after adjusting for other factors (OR, 1.04; P = .78).
Conclusions:
- Elevated preoperative platelet-to-lymphocyte ratio (PLR) is not an independent predictor of postoperative atrial fibrillation (POAF) in patients undergoing isolated coronary artery bypass grafting (CABG).
- These findings contrast with previous smaller studies, suggesting PLR may not be a reliable biomarker for POAF risk stratification in this population.
Background:
Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) and is associated with increased short-term and long-term mortality. While the precise etiology of POAF remains unclear, inflammation is a known contributing factor. Preliminary studies have suggested that an elevated preoperative platelet-to-lymphocyte ratio (PLR), an inexpensive and readily available novel inflammatory biomarker, may be associated with increased incidence of POAF after CABG. This study sought to further investigate this hypothesis.
Methods:
The study cohort included all patients undergoing isolated CABG, with no prior history of arrhythmia, who were operated on between August 1, 2010, and December 31, 2018, at a major Australian tertiary center (n = 1457). Patients were divided into low (<86) or high (≥86) PLR groups based on an optimal cutoff derived from receiver-operating characteristic curve analysis. The incidence of POAF was then compared. Categorical variables were analyzed using the chi-square test and continuous variables using logistic regression.
Results:
Of 1457 patients, 495 (34.0%) developed POAF. There was no statistically significant difference in the incidence of POAF between patients in the high-PLR and low-PLR groups (34.8% vs 31.0%; P = .22). Using multivariable logistic regression analysis, high PLR was not independently associated with POAF (odds ratio, 1.04; P = .78).
Conclusions:
Elevated preoperative PLR is not independently associated with POAF in patients undergoing isolated CABG. The findings of this study differ from those of 2 previous smaller studies.
