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. 2023 Feb 28;21(1):76.
doi: 10.1186/s12916-023-02770-5.

Systemic inflammation indicators and risk of incident arrhythmias in 478,524 individuals: evidence from the UK Biobank cohort

Xiaorong Yang #  1   2 , Shaohua Zhao #  3   4 , Shaohua Wang  5 , Xuelei Cao  6 , Yue Xu  7 , Meichen Yan  7 , Mingmin Pang  7 , Fan Yi  8 , Hao Wang  9
Affiliations

Systemic inflammation indicators and risk of incident arrhythmias in 478,524 individuals: evidence from the UK Biobank cohort

Xiaorong Yang et al. BMC Med. .

Abstract

Background: The role of systemic inflammation in promoting cardiovascular diseases has attracted attention, but its correlation with various arrhythmias remains to be clarified. We aimed to comprehensively assess the association between various indicators of systemic inflammation and atrial fibrillation/flutter (AF), ventricular arrhythmia (VA), and bradyarrhythmia in the UK Biobank cohort.

Methods: After excluding ineligible participants, a total of 478,524 eligible individuals (46.75% male, aged 40-69 years) were enrolled in the study to assess the association between systemic inflammatory indicators and each type of arrhythmia.

Results: After covariates were fully adjusted, CRP levels were found to have an essentially linear positive correlation with the risk of various arrhythmias; neutrophil count, monocyte count, and NLR showed a non-linear positive correlation; and lymphocyte count, SII, PLR, and LMR showed a U-shaped association. VA showed the strongest association with systemic inflammation indicators, and it was followed sequentially by AF and bradyarrhythmia.

Conclusions: Multiple systemic inflammatory indicators showed strong associations with the onset of AF, VA, and bradyarrhythmia, of which the latter two have been rarely studied. Active systemic inflammation management might have favorable effects in reducing the arrhythmia burden and further randomized controlled studies are needed.

Keywords: Atrial fibrillation; Blood-based inflammation markers; Bradyarrhythmia; Systemic inflammation; UK Biobank; Ventricular arrhythmia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flow diagram of the UK biobank participants in this study
Fig. 2
Fig. 2
Multivariable-adjusted association between different systematic information indicators and the risk of atrial fibrillation/flutter by restricted cubic spline regression. A C-reactive protein; B neutrophil count; C monocyte count; D lymphocyte count; E systemic immune-inflammation index (neutrophils × platelets/lymphocytes); F neutrophil-to-lymphocyte ratio (neutrophils/lymphocytes); G platelet-to-lymphocyte ratio (platelets/lymphocytes); H lymphocyte-to-monocyte ratio (lymphocytes/monocytes). HR, hazard ratio; CI, confidence intervals
Fig. 3
Fig. 3
Multivariable-adjusted association between different systematic information indicators and the risk of ventricular arrhythmias by restricted cubic spline regression. A C-reactive protein; B neutrophil count; C monocyte count; D lymphocyte count; E systemic immune-inflammation index (neutrophils × platelets/lymphocytes); F neutrophil-to-lymphocyte ratio (neutrophils/lymphocytes); G platelet-to-lymphocyte ratio (platelets/lymphocytes); H lymphocyte-to-monocyte ratio (lymphocytes/monocytes). HR, hazard ratio; CI, confidence intervals
Fig. 4
Fig. 4
Multivariable-adjusted association between different systematic information indicators and the risk of bradyarrhythmia by restricted cubic spline regression. A C-reactive protein; B neutrophil count; C monocyte count; D lymphocyte count; E systemic immune-inflammation index (neutrophils × platelets/lymphocytes); F neutrophil-to-lymphocyte ratio (neutrophils/lymphocytes); G platelet-to-lymphocyte ratio (platelets/lymphocytes); H lymphocyte-to-monocyte ratio (lymphocytes/monocytes). HR, hazard ratio; CI, confidence intervals
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