Prediction of New-Onset and Recurrent Atrial Fibrillation by Complete Blood Count Tests: A Comprehensive Systematic Review with Meta-Analysis
Alexander Weymann, Sadeq Ali-Hasan-Al-Saegh, Anton Sabashnikov, Aron-Frederik Popov, Seyed Jalil Mirhosseini, Tong Liu, Mohammadreza Lotfaliani, Michel Pompeu Barros de Oliveira Sá, William L. L. Baker, Senol Yavuz, Mohamed Zeriouh, Jae-Sik Jang, Hamidreza Dehghan, Lei Meng, Luca Testa, Fabrizio D'Ascenzo, Umberto Benedetto, Gary Tse, Luis Nombela-Franco, Pascal M. Dohmen, Abhishek J. Deshmukh, Cecilia Linde, Giuseppe Biondi-Zoccai, Gregg W. Stone, Hugh Calkins, Integrated Meta-Analysis of Cardiac Surgery and Cardiology-Group [IMCSC-Group]
Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
Med Sci Monit Basic Res 2017; 23:179-222
Atrial fibrillation (AF) is one of the most critical and frequent arrhythmias precipitating morbidities and mortalities. The complete blood count (CBC) test is an important blood test in clinical practice and is routinely used in the workup of cardiovascular diseases. This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of hematological parameters in the CBC test with new-onset and recurrent AF.
MATERIAL AND METHODS: We conducted a meta-analysis of observational studies evaluating hematologic parameters in patients with new-onset AF and recurrent AF. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity.
RESULTS: The literature search of all major databases retrieved 2150 studies. After screening, 70 studies were analyzed in the meta-analysis on new-onset AF and 23 studies on recurrent AF. Pooled analysis on new-onset AF showed platelet count (PC) (weighted mean difference (WMD)=WMD of –26.39×10^9/L and p<0.001), mean platelet volume (MPV) (WMD=0.42 FL and p<0.001), white blood cell (WBC) (WMD=–0.005×10^9/L and p=0.83), neutrophil to lymphocyte ratio (NLR) (WMD=0.89 and p<0.001), and red blood cell distribution width (RDW) (WMD=0.61% and p<0.001) as associated factors. Pooled analysis on recurrent AF revealed PC (WMD=–2.71×109/L and p=0.59), WBC (WMD=0.20×10^9/L (95% CI: 0.08 to 0.32; p=0.002), NLR (WMD=0.37 and p<0.001), and RDW (WMD=0.28% and p<0.001).
CONCLUSIONS: Hematological parameters have significant ability to predict occurrence and recurrence of AF. Therefore, emphasizing the potential predictive role of hematological parameters for new-onset and recurrent AF, we recommend adding the CBC test to the diagnostic modalities of AF in clinical practice.
Keywords: Atrial Fibrillation, Blood Platelets, Diagnosis, meta-analysis