Predictive Value Of D-D,RDW,and LAD For Left Atrial Thrombosis In Patients With NVAF

Objective: The purpose of this study is to assess the predictive power of D-dime(D-D)r,erythrocyte distribution width(RDW),and left atrial diameter(LAD)tests in patients with NVAF,in order to determine the risk of left atrial thrombosis,and to evaluate the predictive value of the combined test for left atrial thrombosis in patients with NVAF,Method: From June 2019 to June 2022 at the First Affiliated Hospital of Shihezi University School of Medicine,a total of one hundred and sixty-four individuals suffering from non-valvular atrial fibrillation(NVAF)were gathered.All patients were perfected with TEE examination,and the presence of left atrial thrombus was determined according to the TEE examination results into thrombus group(21 cases)and nonthrombus group(143 cases),and general information,serum biomarkers,echocardiogram and the CHA2DS2-VASc score were acquired from the patients and then compared between the two groups.A Binary Logistic regression examination.was conducted to probe the elements that could be responsible for left atrial thrombosis in NVAF patients,The predictive power of D-D,RDW,LAD,and CHA2DS2-VASc scores for left atrial thrombosis in NVAF patients was evaluated by plotting subject operating characteristic curves(ROC)with Medcalc software,a comparison of the four groups’ areas beneath the curve was made to evaluate the predictive power of D-D,RDW,and LAD combined detection for left atrial thrombosis in NVAF patients.Result:1.In the thrombus group,plasma D-D,LAD,RDW,RVD,PDW,and FDP levels were significantly higher than those in the nonthrombus group,yet left ventricular ejection fraction(LVEF)was lower-a difference that was statistically significant.(P < 0.05).2.Compared with the no-thrombus group,the thrombus group had a higher proportion of combined hypertension,The thrombus group had a higher proportion of combined hypertension,diabetes,heart failure,stroke/TIA(P > 0.05),longer duration of atrial fibrillation(P > 0.05),and a higher CHA2DS2-VASc score than the no-thrombus group(P < 0.05),and no statistical distinction was deemed to exist between the two groups in terms of gender,age,and anticoagulant status taken.3.A one-way logistic regression model analysis revealed that plasma D-D,LAD,PDW,RDW,UA,and CHA2DS2-VASc scores were were important factors affecting left atrial thrombosis in patients with NVAF,and a multi-factor logistic regression model was employed to further investigate the potential influence of plasma D-D,LAD,CHA2DS2-VASc score,and RDW on the formation of left atrial thrombosis in those with non-valvular atrial fibrillation,potentially indicating that these factors are independent risk factors.4.By Receiver Operating Characteristics Curve(ROC),the area beneath the LAD and plasma D-D curve was greater.which was 0.841(sensitivity 76.19%,specificity 76.92%)and 0.837(sensitivity 80.95%,specificity 69.93%),respectively.The areas under the curve of RDW and CHA2DS2-VASc scores were0.726 and 0.718,and the sensitivity and specificity of both are 80.95% and 55.94%.A comparison of the ROC curve’s area beneath each index revealed that LAD,RDW,and D-D had a larger area beneath the curve than CHA2DS2-VASc score;however,the disparity between CHA2DS2-VASc score and RDW and D-D’s area beneath the curve was not statistically significant.(P > 0.05),and a statistically significant difference(P< 0.05)was observed in the area beneath the curve with LAD,whereas no significant differences were observed in the other indices(P > 0.05).The AUC of the combined LAD,D-D and RDW for predicting left atrial thrombus in atrial fibrillation was 0.933,with a sensitivity of 90.48% and a specificity of 89.51%,which had a higher predictive value than the three predicting left atrial thrombus independently.area,and the difference between them was statistically significant(P < 0.05).Conclusion: 1.It is certain that Plasma D-D,LAD,RDW,and CHA2DS2-VASc scores can forecast left atrial thrombosis in NVAF patients.2.The value of LAD in predicting left atrial thrombosis in patients with NVAF may be higher than that of CHA2DS2-VASc score.3.The predictive value of left atrial thrombosis in NVAF patients was significantly enhanced when plasma D-D,RDW,and LAD were combined.