Association of Platelet Count, Mean Platelet Volume, Platelet Distribution Width, Plateletcrit, and Platelet–Lymphocyte Ratio With Postoperative Cardiac Surgery–Associated Atrial Fibrillation: A Systematic Review and Meta‐Analysis

Background The predictive value of platelet indices, including the platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet–lymphocyte ratio (PLR) for postoperative atrial fibrillation (POAF) following cardiac surgery remains undetermined. Methods MEDLINE, Embase, and the Cochrane Library were searched from inception to October 2024. For each included study, median differences (MDs) and odds ratios (ORs) were tabulated with 95% confidence intervals (CIs). Pooled estimates were generated using random‐effects inverse‐variance modeling. Statistical analysis focused on cases of POAF. Results Six thousand five hundred and seventeen unique studies were screened and included 23 studies involving 12,375 patients in the subsequent analysis. Compared with patients who did not develop POAF, patients with POAF had higher preoperative MPV (MD: 0.30 fL, 95% CI: 0.07–0.53, and p = 0.0112) and PLR (MD: 40.42, 95% CI: 7.49–73.33, and p = 0.0161). Preoperative PLT (MD: 3.32, 95% CI: −5.87–12.51, and p = 0.4785) was not significantly different between groups. Study numbers were insufficient to assess the association between PCT with POAF. Conclusion Elevated preoperative MPV and PLR were associated with POAF after cardiac surgery. Further research is required to investigate the roles of these indices in the risk stratification of POAF in patients undergoing cardiac surgery.