Evaluation and comparison of inflammatory and albumin-based markers in left-sided mechanical heart valve thrombosis

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Abstract
Introduction: Mechanical valve thrombosis (MVT), along with its associated embolic or obstructive complications, can have significant clinical implications. Studies evaluating the relationship of inflammatory and albumin-based markers such as neutrophile-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), C-reactive protein to albumin ratio, uric acid to albumin ratio and lactate dehydrogenase to albumin ratio (LAR) with thrombosis burden in patients with left sided mechanical valves are lacking. We aimed to examine the relationship between inflammatory and albumin-based markers, and left sided MVT with and without obstruction. Methods: Eighty-eight patients (age 48.9±13.8, 72.7% female) with left-sided MVT were included in the study. Patients were divided into two groups as obstructive thrombosis (OT) and non-obstructive thrombosis (NOT). Results: NLR, PLR and LAR levels were found to be significantly higher in OT group (P<0.001, P<0.001; P=0.032, respectively). There was a strong correlation between OT and both NLR and PLR (r=0.736 and r=0.645). Of those markers, NLR (odds ratio (OR) 5.68, 95% confidence interval (CI) 1.96 to 16.48, P=0.001) was found to be the independent predictor of OT. On receiver operating characteristic (ROC) analysis, a cut-off value 2.83 of NLR (area under the curve (AUC)=0.931; 95% CI:0.877-0.984; P<0.001) had 86.3% sensitivity and 86.5% specificity for prediction of OT. Conclusion: Increased NLR, PLR, and LAR values were associated with OT in left-sided MVT. Of those, NLR was found to be the most sensitive and specific marker and represented as an independent predictor of OT.

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