Study On The Related Factors Of Acute Ischemic Stroke In Patients With Non-valvular Atrial Fibrillation

Objective: To investigate the predictive value of the neutrophil lymphocyte ratio（NLR）,red cell distribution width（RDW）,fibrinogen（FIB）,left atria diameter（LAD）combined with atrial fibrillation risk stroke assessment scale（CHA2DS2-VASc score scale）for non-valvular atrial fibrillation（NVAF）patients of ourccencing with acute ischemic stroke（AIS）.Methods: Selected 256 patients with non-valvular atrial fibrillation diagnosed in our hospital from October 2019 to December 2021.After screening according to the inclusion and exclusion criteria,225 patients with NVAF were finally included in this study.According to whether they were complicated with acute ischemic stroke or not,they were divided into observation group and control group,the observation group was patients with non-valvular atrial fibrillation complicated with acute ischemic stroke,and the control group was patients with simple non-valvular atrial fibrillation.The general data of the two groups of patients（age,gender,smoking history,underlying medical history,etc.）,laboratory hematology indicators（neutrophil/lymphocyte ratio（NLR）,red blood cell volume distribution width（RDW）,fibrinogen（FIB）,etc.）,imaging Indicators(left ventricular ejection fraction（LVEF）,left atrial diameter（LAD）level and related scales（CHA2DS2-VASc score scale）scores are recorded separately.Elbow venous blood was taken from all patients more than 8 hours after admission,and the measurement was uniformly completed by the clinical Laboratory of our hospital.After admission,imaging examinations were carried out in the radiology department of our hospita,and the scale was improved.Through corresponding statistical methods,the relevant risk factors of acute ischemic stroke in patients with non-valvular atrial fibrillation were analyzed,and the CHA2DS2-VASc score was combined to explore the predictive value of combined indicators on patients with non-valvular atrial fibrillation complicated with acute ischemia stroke.Results:1.There was no significant difference in gender,smoking history,hypertension history,diabetes history,heart failure history,anticoagulant use,TC,TG,LDL-C,UA,NT-pro BNP and HAblc between the two groups（P>0.05）;The age,coronary heart disease,NLR,RDW,FIB,LAD and CHA2DS2-VASc scores in the observation group were higher than those in the control group,and the difference was statistically significant（P<0.05）,while the level of LVEF was lower than that in the control group,and the difference was statistically significant（P<0.05）.2.NLR,RDW,FIB and LAD were risk factors for acute ischemic stroke in patients with non-valvular atrial fibrillation（OR values were 1.682,1.491,1.904,1.115,respectively）,and the differences were statistically significant（P<0.05）.3.The levels of NLR,RDW,FIB,and LAD were positively correlated with the CHA2DS2-VASc score,and the difference was statistically significant（P<0.05）.4.The areas（AUC）under the receiver operating curve（ROC）of NLR,RDW,FIB,LAD,CHA2DS2-VASc scores for predicting the risk of stroke in patients with non-valvular atrial fibrillation were 0.703,0.716,0.661,0.709,0.783;The area under the ROC curve（AUC）constructed by four indicators combined with CHA2DS2-VASc score was the largest,which was 0.868;among the five indicators,the CHA2DS2-VASc score alone had higher sensitivity and specificity in diagnosing NVAF with AIS,72.6% and74.8%,respectively;the sensitivity and specificity of model 5 in diagnosing NVAF with AIS increased respectively,which were 74.2% and 85.3%.Conclusions:1.NLR,RDW,FIB and LAD are risk factors for acute ischemic stroke in patients with non-valvular atrial fibrillation.2.NLR,RDW,FIB,LAD combined with CHA2DS2-VASc score scale has higher sensitivity and specificity in the predicting of non-valvular atrial fibrillation patients with secondary acute ischemic stroke,which could be used as a more valuable combined indicator for early prediction of acute ischemic stroke in patients with non-valvular atrial fibrillation.