Analysis Of The Risk Factors Of Ischemic Stroke Recurrence In Patients With Atrial Fibrillation

Objective: Atrial fibrillation （AF） is a common clinical tycharrhythmia.It refers to that normal cardiac electrical activity disappears, and is replaced byfast abnormal atria fibrillation waves. Blood flows slowly here, which formsthrombus easily and causes thromboembolic complications. Atrial fibrillationis the independent risk factor of stroke. Stroke brings heavy economicburden on families and society for its disability and lethality. This study is tofind the independent risk factors of stroke recurrence by analyzing recurrenceof stroke related factors in patients with atrial fibrillation combined stroke, anddiscuss the influences of antithrombotic drugs on stroke recurrence, and thenanalyze whether there is difference between aspirin and warfarin on strokerecurrence prevention.Methods:1Subjects: Choose cerebral apoplexy patients with atrial fibrillation whowere hospitalized in neurological department of the second hospital, HebeiMedical University between April2006and April2011. There were a total of415cases, including184male cases （44.3%） and231female cases （55.7%）.The average age was68.60±11.24.（28⁹2）.2Methods: Conduct Retrospective analysis of the patients and collect therelevant clinical data, such as: sex, age, hypertension, hyperlipidemia, diabetes,heart failure, smoking, drinking, peripheral vascular disease, whether usingantithrombotic drugs, whether combined valvular disease, etc. The selectedpatients showed clear symptoms of nervous system, and diagnosis of ischemicstroke were confirmed by CT or MRI. These patients had a clear history ofatrial fibrillation or were found with atrial fibrillation by electrocardiogram or24-hour dynamic electrocardiogram examination. The scores of350patientswith non valvular disease were assessed by CHA₂DS₂-VASc scoring system and were not less than2. We gave follow-up calls to all patients who couldbe reached to ask about the recurrence of stroke and cerebral apoplexy in twoyears from the first stroke and whether they had regular medicationcompliance. Stroke recurrence was considered as new neurological symptomsappeared, and confirmed ischemic stroke by head CT or MRI. The end pointevents were ischemic cerebral apoplexy, thrombosis, embolism or death. Thecollected cases could be divided into two groups according to the strokerecurrence. Then we analyzed whether sex, age, hypertension, hyperlipidemiaand diabetes were the risk factors for stroke recurrence in patients with atrialfibrillation.3Statistical analysis: Creating a database through the application ofSPSS19.0software package for statistical analysis. Using SPSS19.0softwarepackage to establish database for statistical analysis. The measurement datawere expressed as mean±standard deviation （x±s）. The count data wereexpressed as a percentage. Use the Logistic regression analysis to find theindependent risk factors of stroke recurrence in patients with atrial fibrillation.P＜0.05was considered statistically significant.Results: In this study, the average age was68.60±11.24（28⁹2） in415cases,184males （44.3%） and231females （55.7%）. the cumulativerecurrence of the144recurrence cases rate was34.7%,271cases （65.3%） ofno recurrence.65cases （15.7%）with valvular disease and350cases （84.3%）not with combined valvular disease.91cases （21.9%） end of death.257cases（61.9%） combined hypertension,36cases （8.7%） combined hyperlipidemia,111cases with diabetes mellitus （26.7%）,46cases （11.1%） combined heartfailure,75cases （18.1%） had a history of alcohol consumption,92cases（22.2%） had a smoking history,219cases （52.8%）combined vascular disease.160cases （38.6%） did not use any antithrombotic drugs,155cases （37.3%）used aspirin antiplatelet,32cases （7.7%） used warfarin anticoagulation,47cases （11.3%） application of clopidogrel and21cases （8.2%） used aspirincombined clopidogrel antiplatelet. Only56patients took medication regularlyaccounting for only22%of the patients who took medication, only3（9.4%） patients took warfarin monitor INR values. In the350cases with non valvulardisease,130cases （37.1%） of them took aspirin,24cases （6.9%） of them tookwarfarin,42cases （12.0%） of them took clopidogrel, and19cases （5.4%） ofthem took aspirin and clopidogrel, the other135cases （38.6%） took nomedication. We used logistic regression to analyze and found thathypertension, hyperlipidemia, diabetes, smoking history, vascular diseasewere the risk factors for stroke recurrence in patients with atrial fibrillation （P<0.05）.Conclusion: In this study, through the logistic regression analysis, theindependent risk factors of stroke recurrence in patients with atrial fibrillationare hypertension, hyperlipidemia, diabetes, smoking history, vascular disease.Taking antithrombotic drugs such as aspirin, clopidogrel, and warfarin hasprevental function on the recurrence of stroke. Anticoagulation ability inpatients with atrial fibrillation in clinical is weak. Compared with clopidogrel,warfarin and combined antiplatelet medication, patients adhered to aspirinwell. Only9.4%adhered to the monitoring of INR in patients who used...