Association Between Platelet/Lymphocyte Ratio and CHA2DS2-VASc Score in Patients with Nonvalvular Atrial Fibrillation

Abstract

Introduction: The most commonly used scoring system in determining the risk of thromboembolism in atrial fibrillation (AF) patients is CHA2DS2-VASc score. Platelet/lymphocyte ratio (PLR) is recently reported as an important indicator of inflammation especially in patients with malignancy. In this study, our aim was to investigate the association between PLR and CHA2DS2-VASc scores in patients with nonvalvular AF. Patients and Methods: In this retrospective study, medical records of 184 patients (Mean age 6 8 ± 11.4 years and 51.6% men) admitted to our clinic with nonvalvular AF between the years 2010 and 2016 were examined. Results: Patients with high risk of stroke according to CHA2DS2-VASc score had greater PLR, less left ventricular ejection fraction (LVEF), and less white blood cell counts compared to those of low and moderate risk groups combined. Glomerular filtration rate (GFR) values were also found lower in high risk group, albeit with a borderline statistical significance. In correlation analysis, CHA2DS2-VASc score demonstrated moderate positive correlation with PLR (r= 0.3, p< 0.01), moderate negative correlation with LVEF (r= -0.383, p< 0.01), and a weak negative correlation with GFR (r= -0.235, p= 0.01) and WBC (r= -0.235, p= 0.01). In multivariate logistic regression analysis, PLR and LVEF were shown to be independent predictors of CHA2DS2-VASc score. Area under the curve (AUC) was 0.61 (0.53-0.7, p< 0.05) for PLR and 0.69 (0.61-0.77, p< 0.001) for LVEF. The PLR value 112.5 predicted high CHA2DS2-VASc scores with a sensitivity of 65% and specifity of 61%. Conclusion: Our findings suggest PLR as a predictor of CHA2DS2-VASc scores in patients with nonvalvular AF.