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

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.