Abstract
Objective: The pan-immune inflammatory (PIV) index holds prognostic value for cardiovascular diseases. This study aimed to investigate the predictive value of the PIV index regarding recurrence of atrial fibrillation (AF) after cryoballoon ablation (CBA).
Methods: The study included 307 patients with AF. Four inflammatory markers, namely, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation (SII) index, and PIV index, were used as indicators. COX regression analysis was conducted to evaluate the predictive value of AF recurrence after CBA. A receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the discriminative power of the indicators.
Result：The PIV index [94.9 (168.9,504.9) vs. 143.2 (98.2,210.6), P< 0.01] and SII index [366.3 (256.6,491.9) vs. 569.9 (658.1,438.4), P<0.01] were significantly higher in the recurrence group. Univariate COX regression analysis showed that these four indices, persistent AF, and left atrial diameter (LAD) were all associated with AF recurrence. In multivariate regression analysis, the PIV index, persistent AF, and LAD (all P < 0.05) were independent predictors of postoperative AF recurrence. The ROC curve analysis showed that the PIV index had a higher predictive value for AF recurrence (AUC = 0.768, P < 0.01, 95% CI: 0.696–0.840) than the SII index and NLR. Kaplan–Meier analysis showed that patients with a PIV index > 260.7 had a higher recurrence rate at 1-year follow-up (P < 0.01). Subgroup analysis indicated that PIV had a predictive value in patients with different types of AF.
Conclusion：PIV index may be a potential biomarker for predicting relapse in patients with non-valvular AF after CBA.