Cardiovascular Journal of Africa: Vol 32 No 4 (JULY/AUGUST 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 4, July/August 2021

AFRICA

181

number of studies and clinical practice that NLR serves as

an evaluation index for diagnosis and prognosis of patients with

cardiac insufficiency.

Determining NLR in plasma in patients

with CHF and AF has been a subject of study in recent years. It is

currently believed that NLR is an ideal marker of myocardial injury,

and the level has a significant positive correlation with the degree of

myocardial injury.

NLR has predictive value for the prognosis of a variety of

cardiovascular diseases.

Patients with coronary heart disease have

a higher NLR in plasma.

Furthermore, NLR in plasma is higher

in patients with acute myocardial infarction than that in patients

with unstable angina, while it is also higher in the latter than

that in patients with stable angina. After correcting for a variety

of traditional cardiovascular risk factors, NLR can be used as a

predictor for major adverse events of AF.

In our study, the results

of logistic regression analysis showed that NLR was an independent

predictive factor for MACE in patients with CHF and AF.

In our study, the patients were divided into four groups based on

the quartile of NLR. It was found that the difference in incidence

of MACE was statistically significant between the four groups (

< 0.05), manifesting as increased incidence of acute myocardial

infarction, severe arrhythmia and cardiac death with increasing

NLR. AF raises both resting heart rate and response heart

rate, further reducing cardiac output and elevating cardiac filling

pressure, which is the internal cause of aggravation of HF by AF

and an important factor causing acute myocardial infarction.

AF is

a common type of arrhythmia, and CHF can further enhance atrial

depolarisation and repolarisation dispersion and cause re-entry

more easily, thereby leading to severe arrhythmia.

In this study, according to the analysis results of Kaplan–Meier

survival curves, the duration of MACE in group D was significantly

shorter than that in groups A and B. Yýlmaz

et al

. demonstrated

that NLR > 3.08 was an independent predictor of new-onset

myocardial infarction and in-hospital death in patients with HF.

In our study, the ROC curves showed that the optimal cut-off value

and area under the curve of NLR for MACE in patients with CHF

and AF were 3.12 and 0.879, respectively, confirming their high

diagnostic value.

Conclusion

NLR was an independent predictive factor for MACE in these

patients with CHF and AF, and it had high diagnostic value, which

is of importance for adopting the appropriate therapeutic regimen

and improving prognosis as early as possible.

This study was financially supported by Xintai Research and Development

Project (No 2020ZC272).

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