Association Of Homocysteine And Troponin T With The Risk Of Thrombotic Events In Patients With Nonvalvular Atrial Fibrillation

Objective:The relationship between serum Homocysteine（Hcy）and Cardiac Troponin T（Tn T）and thrombotic events in patients with Nonvalvular atrial fibrillation（NVAF）was analyzed.To explore whether it can provide predictive value for the risk of thrombosis in NVAF population,provide a more convenient and easy detection method,and provide a new idea for the prevention and treatment of NVAF thrombosis events.Methods:A total of 175 NVAF cases were collected according to inclusion and exclusion criteria.The basic information,biochemical indices,and cardiac color doppler ultrasound indexes of the patients were collated,and the CHA₂DS₂-VASC score was calculated.According to the definition of thrombotic events,the patients were divided into NVAF non-thrombotic group and NVAF thrombotic group.AF)the above groups were divided into subgroup A:paroxysmal AF non-thrombotic group and paroxysmal AF thrombotic group;Subgroup B:persistent AF non-thrombotic group and persistent AF thrombotic group.The influence of the above indicators on the occurrence of thrombotic events and the predictive values of Hcy and Tn T on the risk of thrombosis were analyzed and discussed.Results:（1）Comparison between NVAF thrombus group and non-thrombus group:There were statistically significant differences in age,smoking,history of hypertension,history of vascular disease,CHA₂DS₂-VASC scores≥2 points,AF classification,Hcy,Tn T,C-reactive protein,D-dimer,N-terminal B-type natriuretic peptide,neutrophil count,aspartate aminotransferase,left atrial diameter,left ventricular end-diastolic diameter and other indicators（P<0.05）.（2）Subgroup A:There were statistically significant differences in Hcy and Tn T between the non-thrombotic group and the paroxysmal AF thrombotic group（P<0.05）;Subgroup B:There were statistically significant differences in Hcy,Tn T,C-reactive protein and D-dimer between the non-thrombotic group and the persistent AF thrombotic group（P<0.05）.（3）Multivariate binary logistic regression analysis showed that Hcy（OR=1.158）,Tn T（OR=1.093）and CHA₂DS₂-VASC scores≥2 points（OR=17.351） were statistically significant（P<0.05）.4.The area under ROC curve of Hcy,Tn T,CHA₂DS₂-VASC≥2,and CHA2DS2-VASC≥2 combined with Tn T for predicting thrombotic events was 0.792（95%CI:0.726-0.858;P<0.05）,0.831（95%CI:0.769-0.893;P<0.05）,0.718（95%CI:0.643-0.792;P<0.05）,0.917（95%CI:0.870-0.965;P<0.05）.Conclusions:（1）Hcy,Tn T and CHA₂DS₂-VASC scores≥2 were independent risk factors for thromboembolism in NVAF patients.（2）Tn T,Hcy and CHA₂DS₂-VASC scores≥2 have predictive values for NVAF thrombosis events.（3）Tn T combined with CHA₂DS₂-VASC scores≥2 points can provide a detection method for patients with clinical NVAF thromboembolism.