Key result
Elevated neutrophil-to-lymphocyte ratio linked to ~140% higher LAA thrombus risk in anticoagulated non-valvular AF patients.
Why the study?
AF increases thromboembolic risk via left atrial appendage thrombus and atrial cardiomyopathy, prompting an analysis of additional factors associated with thrombus presence despite oral anticoagulant therapy.
Observational (n=88)
No
Effect estimate: OR 2.4 (95% CI 1.1630-4.9667)
p-value: p=0.002
In patients with non-valvular atrial fibrillation on oral anticoagulants, female sex, CHA2DS2-VA score, HAS-BLED score, left atrial size, and neutrophil-to-lymphocyte ratio are independently associated with the presence of left atrial appendage thrombus.
Should not yet change LAA thrombus screening in anticoagulated nonvalvular AF; hypothesis-generating for NLR in risk models.
Background. Atrial fibrillation is the most common type of arrhythmia and, due to thrombus formation in the left atrial appendage, is associated with a significant increase in the risk of thromboembolic complications, primarily ischemic stroke, transient ischemic attack, and peripheral thromboembolism. According to current concepts, the presence of atrial fibrillation contributes to the development of atrial cardiomyopathy, which includes structural and electrical atrial remodeling, induction of apoptosis, and possibly the development of immunothrombosis. Purpose – to analyze additional factors that may be associated with the presence of a thrombus in the left atrial appendage in patients with non-valvular atrial fibrillation receiving oral anticoagulant therapy. Materials and Methods. A total of 88 patients with non-valvular atrial fibrillation were included in the analysis. All patients underwent transesophageal echocardiography. Clinical parameters, transthoracic echocardiographic data, the neutrophil-to-lymphocyte ratio, and the platelet-to-lymphocyte ratio were assessed. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with the development of left atrial appendage thrombosis. Results. In 33 patients (37.5%), a thrombus in the left atrial appendage was detected during transesophageal echocardiography (Group I). Group II included 54 patients (62.5%) without left atrial appendage thrombus. According to the analysis, independent factors associated with the presence of left atrial appendage thrombus in patients with non-valvular atrial fibrillation included known factors such as female sex (OR = 5.7; 95% CI [1.3319–24.4224]; p = 0.02), CHA2DS2-VA score (OR = 2.0; 95% CI [1.0849–3.8067]; p = 0.03), HAS-BLED score (OR = 0.3; 95% CI [0.0830–0.8502]; p = 0.02), left atrial size (OR = 7.5; 95% CI [1.1246–51.6998]; p = 0.004), as well as the neutrophil-to-lymphocyte ratio (OR = 2.4; 95% CI [1.1630–4.9667]; p = 0.002). Conclusions. The presence of left atrial appendage thrombus in patients with non-valvular atrial fibrillation receiving anticoagulant therapy is associated with a range of clinical, instrumental, and laboratory parameters. Determination of the platelet-to- lymphocyte ratio may be a promising marker for predicting the risk of thrombus formation in the left atrial appendage.
No takes yet. Share an insight, caveat, or question.
Yakovleva et al. (2025) conducted an observational in Non-valvular atrial fibrillation (n=88). Risk factor assessment (Neutrophil-to-lymphocyte ratio) was evaluated on Presence of left atrial appendage thrombus (OR 2.4, 95% CI 1.1630-4.9667, p=0.002). An elevated neutrophil-to-lymphocyte ratio was independently associated with the presence of left atrial appendage thrombus in patients with non-valvular atrial fibrillation receiving oral anticoagulants (OR 2.4).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: