الفهرس 
Acknowledgement
Inflammatory Markers of Atrial FibrillationOnly 14 pages are availabe for public view
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Abstract
This study was done on.Patient group included 50 patients of chronic atrial fibrillation, Age of the patients ranged from 43 to 80 years old, including 41 males and 9 females. Control Group: included 35 apparently healthy individuals (21 males and 14 females), their age ranged from 49 to 78 years old. The following investigations were done for all the studied persons: 1-Liver enzymes test (ALT, AST) 2-Kidney function test (urea, creatinine) 3-Complete Blood Counts (CBC) including MPV, NLR. 4-Prothrombin time, concentration and INR5- Serum CRP6- Serum IL-6 Patients were classified according toCHA2DS2-VASc score into: 1- Low risk included 5 patients2- Moderate risk included 16 patients 3- High risk included 29 patients HAS-BLED score into: 1- Low risk: included 33 patients 2- High risk: included 17 patients. The summary of the results: Demographic and clinical data of the studied groups: It was noticed that body mass index of patient group was significantly higher in comparison to the control group. Out of the patient group; 24 (48%) were diabetics, 24 (48%) were hypertensive and 27 (54%) patients were smokers. Echocardiography among the studied groups: The patients group had significantly higher left atrium diameter than the control group. The ejection fraction was significantly lower in the patient group compared to the control group. Routine laboratory investigations among the studied groups: It was noticed that patients had significantly lower hemoglobin concentration than control group. Significant higher activity of aspartate transaminase (AST) was found in the patients group compared to control group. Significant elevation of international normalization ratio (INR) was found in the patients group in comparison to the control group. No statistical significant difference was found between patients and control groups regarding; platelets count, total leucocytic count, urea, creatinine, and alanine transaminase (ALT Inflammatory biomarkers among the studied groups: There was statistically significant elevation of Mean Platelet Volume (MPV) in the patient group compared to the control group. C-reactive protein (CRP) shows statistically significant elevation in the patient group than the control group. Serum level of Interleukin-6 (IL-6) was significantly higher among patients group in comparison to the control group. Neutrophil to Lymphocyte Ratio (NLR), no statistical significant difference was found between patients and controls. Echocardiography data and Inflammatory Biomarkers in the studied patients according to CHA2DS2VASc score: The left atrial diameter was significantly higher in patients with high risk in comparison to those with low risk and those with intermediate risk. No statistical significant difference was found in patients with various risk scores regarding the ejection fraction. There was statistical significant elevation of serum level of CRP and IL-6 in patients with high risk in comparison to those with low risk and those with intermediate risk. No statistical significant difference was found in Neutrophil to Lymphocyte Ratio (NLR) and mean platelet value (MPV) when comparing patients at different CHA2DS2VASc risk scores. Echocardiography data and Inflammatory Biomarkers in the studied patients classified according to HAS-BLED score: Left atrial diameter was significantly higher in patients with high risk in comparison to those with low risk. Ejection fraction was insignificant difference in patients with high risk in comparison to those with low risk. Serum CRP and IL-6 was significantly higher in patients with high risk in comparison to those with low risk. Both Neutrophil to Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) didn’t show statistical significant difference when comparing low risk and high risk groups of patients. Correlation between risk scores and demographic & laboratory variables in AF patients: CHA2DS2VASc score had positive correlation with age, CRP, AST, IL-6 and LA diameter. But, it has negative correlation with hemoglobin level, platelets count and ejection fraction. HAS-BLED score had positive correlation with age, CRP, AST, IL-6 and LA diameter. But, it has negative correlation with hemoglobin level, platelets count and ejection fraction. No statistical significant correlations was found between risk scores and other variables. Interleukin-6 has positive correlation with CRP In Univariate analysis Body mass index, Diabetes mellitus, Hypertension, Mean platelets volume, C-reactive protein and Interleukin-6 were found to be predictors of high risk group in AF patients.In Multivariate analysis only Interleukin-6 is the predictor of high risk ROC curve analysis done to assess the accuracy of IL-6 in risk prediction , at cut off point > 34 pg/ml, IL-6 had 86% sensitivity and 89% specificity with overall accuracy 86% and area under curve 0.89. ROC curve analysis done to assess the accuracy of CRP 6 in risk prediction, at cut off point > 4.2 mg/dl had 87% sensitivity and 69% specificity with overall accuracy was 78% for diagnosis of chronic AF with area under curve was 0.69. Combined CRP/IL-6 had 100% sensitivity and 58% specificity with overall accuracy was 82% for prediction of stroke in chronic AF with area under curve was 0.79.