Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 16;15(6):960.
doi: 10.3390/life15060960.

The Role of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Predicting Atrial Fibrillation and Its Comorbidities

Evelina Maria Gosav  1   2 , Daniela Maria Tanase  1   2 , Anca Ouatu  1   2 , Oana Nicoleta Buliga-Finis  1   2 , Diana Popescu  1   2 , Cristina Gena Dascalu  3 , Nicoleta Dima  1   2 , Minerva Codruta Badescu  1   2 , Ciprian Rezus  1   2
Affiliations

The Role of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Predicting Atrial Fibrillation and Its Comorbidities

Evelina Maria Gosav et al. Life (Basel). .

Abstract

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias encountered globally, characterized by a pro-inflammatory pattern. This analysis evaluated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with AF alongside chronic kidney disease (CKD) and/or type 2 diabetes mellitus (T2DM). This retrospective cohort study included 6077 patients admitted to the Third Medical Clinic of Saint Spiridon Hospital in Iasi from 2018 to 2023, all diagnosed with AF, CKD, and T2DM. After applying the exclusion criteria, 1066 AF patients remained eligible. For a multivariate comparative analysis, the patients were divided into groups: I. control group (non-AF patients); II. AF patients; III. T2DM group; IV. CKD-only group; V. AF+CKD group; VI. AF+T2DM group; and VII. AF+T2DM+CKD group. The Mann-Whitney/Kruskal-Wallis test demonstrated a statistically significant difference in NLR and PLR values between the AF group and the non-AF group (H = 70.627, p < 0.001). The receiver operating characteristic (ROC) analysis identified statistical significance and predictive power for NLR (AUC = 0.722; sensitivity = 63.6%; specificity = 76.9%) and neutrophil count in diagnosing AF, T2DM, and CKD. In conclusion, this study illustrated the utility of NLR and PLR as readily available and predictive biomarkers of inflammation in patients with AF, with or without comorbidities.

Keywords: AF; CKD; NLR; PLR; T2DM; atrial fibrillation; chronic kidney disease; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; type 2 diabetes mellitus.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Consort flow diagram of the patients included. Cardiomyopathy (CM); coronary artery disease (CAD); acute kidney injury (AKI); atrial fibrillation (AF); type 2 diabetes mellitus (T2DM); chronic kidney disease (CKD); white blood cell (WBC).
Figure 2
Figure 2
ROC curve of NLR, PLR, neutrophils, lymphocytes, and platelets in AF diagnoses.
Figure 3
Figure 3
Quality of ROC models of NLR, PLR, neutrophils, lymphocytes, and platelets in AF diagnoses. The dashed line represents a non-discriminatory test, a random classifier, which assigns 1 and 0 randomly to the samples for model quality assessment.
See this image and copyright information in PMC

References

    1. Van Gelder I.C., Rienstra M., Bunting K.V., Casado-Arroyo R., Caso V., Crijns H.J.G.M., De Potter T.J.R., Dwight J., Guasti L., Hanke T., et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): Developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO) Eur. Heart J. 2024;45:3314–3414. doi: 10.1093/eurheartj/ehae176. - DOI - PubMed
    1. Joglar J.A., Chung M.K., Armbruster A.L., Benjamin E.J., Chyou J.Y., Cronin E.M., Deswal A., Eckhardt L.L., Goldberger Z.D., Gopinathannair R., et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149:e1–e156. doi: 10.1161/CIR.0000000000001193. - DOI - PMC - PubMed
    1. Wang M., An G., Wang B., Chen Y., Liu G., Wang X., Liu S., Zhang D., Sun D., Zhang Y., et al. Integrated analysis of the lncRNA-miRNA-mRNA network based on competing endogenous RNA in atrial fibrillation. Front. Cardiovasc. Med. 2023;10:1099124. doi: 10.3389/fcvm.2023.1099124. - DOI - PMC - PubMed
    1. Mukai Y. Inflammation and atrial fibrillation. J. Arrhythm. 2024;40:26–27. doi: 10.1002/joa3.12984. - DOI - PMC - PubMed
    1. Keefe J.A., Zhao S., Wehrens X.H.T. A mechanistic LNK between inflammation and atrial fibrillation? Cardiovasc. Res. 2024;120:814–816. doi: 10.1093/cvr/cvae083. - DOI - PMC - PubMed

LinkOut - more resources