Retrospective Analysis Of The Influence Factors For Stroke In Patients With NVAF

Objective To explore the influence factors for stroke in patients withnonvalvular atrial fibrillation（NVAF）.Methods A retrospective analysis was performed on patients with non-valvular atrial fibrillation (N=975) from January2009to March2013. Thepatients were divided into stroke group (case group,n=254) and non-strokegroup (control group,n=721). The clinical dates such as in general state of health,associated diseases, blood biochemical index, cardiac ultrasound and clinicaltreatment were compared between two group, and logistic regression analysiswas applied to determine the risk factors and the protective factors for stroke.We also evaluate the clinical treatment on the impact of the incidence of strokein patients.Results Univariate analysis showed that significant influence factors forstroke in patients with NVAF were age, age≥60，hypertension, diabetes mellitus,body mass index(BMI), C reactive protein（CRP）, uric acid, fasting bloodglucose, triglyceride(TG), low density lipoprotein cholesterol(LDL-C),lipoprotein(a), left atrial thrombus, left ventricular diastolic diameter(LVDd), left ventricular ejection fraction(LVEF), antithrombotic drugs (aspirin，warfarinand dual antiplatelet), drug therapy for ventricular rate control(Metoprolol)，antiarrhythmic drugs (propafenone, amiodarone)， angiotensin-convertingenzyme inhibitor/angiotensin receptor blocker(ACEI/ARB) and catheterradiofrequency ablation (pulmonary vein isolation)(P<0.05).Multivariate Logistic regression analysis showed: age≥60, BMI,hypertension, left ventricular systolic dysfunction, CRP, fasting blood glucose,lipoprotein(a) are independent risk factors for stroke patients withNVAF(P<0.05). While warfarin, aspirin, antiarrhythmic drugs (propafenone,amiodarone)，ACEI/ARB and catheter radiofrequency ablation treatment areprotective factors for stroke patients with NVAF (P<0.05).Conclusion In addition to age≥60, hypertension, and left ventricularsystolic dysfunction, CRP, fasting blood glucose, lipoprotein (a) levels and BMIare also independent risk factors for stroke patients with nonvalvular atrialfibrillation， conducive to predict the risk of stroke in nonvalvular atrialfibrillation. While using warfarin, aspirin, antiarrhythmic drugs (propafenone,amiodarone), ACEI/ARB and catheter radiofrequency ablation (pulmonary veinisolation) treatment are protective factors for stroke patients with nonvalvularatrial fibrillation，which can prevent and reduce the incidence of stroke withnonvalvular atrial fibrillation.