Clinical Investigation Of High-risk Nonvalvular Atrial Fibrillation Stroke Based On The CHADS₂ Score

Objective:By comparing CHADS₂ and CHA₂DS₂-VASc scores in patients with nonvalvular atrial fibrillation,and based on the CHADS₂ score to explore the clinical characteristics,stroke risk factors and interventions of high risk of stroke patients with nonvalvular atrial fibrillation,provide the basis for the prevention and treatment of high risk of stroke patients with nonvalvular atrial fibrillation.Methods:2528 in hospital patients in neurology and cardiology between January 2014 to December 2014 with nonvalvular atrial fibrillation data were retrospectively analyzed.According to whether the merger of stroke patients can be divided into two groups,collect demographic data and clinical characteristics of patients in all patients with CHADS₂,CHA₂DS₂-VASc and HAS BLED scores,evaluation of patients with stroke and bleeding risk;application CHADS₂ score in patients with cerebral stroke risk groups,divided into high,medium and low risk groups,intervention measures,such as information data statistics,analysis of stroke patients with nonvalvular atrial fibrillation at high risk of stroke associated with sex,age,blood glucose,blood lipid and blood pressure levels,heart function and the relationship between BMI.Results:1.The combined stroke/TIA patients with nonvalvular atrial fibrillation combined stroke/TIA patients with gender and diabetes prevalence statistically difference between two groups?P < 0.05?,age composition,hypertension prevalence no statistical difference?P > 0.05?,but each is statistically significant between age groups?P < 0.001?.Results showed that the merger stroke/TIA and stroke/TIA patients,compared to women and elderly patients,diabetes prevalence rate is high.2.The CHADS₂,CHA₂DS₂-VASc score assess the risk of stroke patients with nonvalvular atrial fibrillation,CHADS₂ score in the high-risk group of 1836 people,moderate group of 544 people,148,low-risk group CHA₂DS₂-VASc score in the high-risk group of 2389 people,moderate group of 93 people,low-risk group of 46 people,the result shows: the CHA₂DS₂-VASc score a CHADS₂ score screening patients at high risk of stroke/TIA is much less,low-risk patients.3.Respectively for CHADS₂ and CHA₂DS₂-VASc score high,medium and low risk group of patients with HAS-BLED score,CHADS₂ score high,medium and low risk of stroke group HAS-BLED score were 3.91±0.89,2.47± 0.49,2.05±0.56,CHA₂DS₂-VASc score high,medium and low risk of stroke group HAS-BLED score were score were 4.05±1.31,2.96±0.57,2.61±0.43,the results showed: CHADS₂ and CHA₂DS₂-VASc scores in patients at high risk of stroke/TIA HAS-BLED score is higher,and stroke,low-risk patients bleeding score there were significant differences?P < 0.001?.4.According to the results of the CHADS₂ score high-risk group of patients with stroke,1836 people,including 221 people in the use of anticoagulant drugs?12.0%?,moderate group of patients,544 people,including anticoagulation 41?7.5%?,platelet aggregation in treatment of 345 people?63.4%?;From 2014 to 2016,neurology patients at high risk of stroke in atrial fibrillation anticoagulation intervention were 5.78%,9.58%,5.78%,heart patients at high risk of stroke in atrial fibrillation with anticoagulation interference ratio of 9.87%,11.11% and 17.36% respectively.Results show that: the study patients with anticoagulant intervention overall rate is low;Annual proportion compare anticoagulant intervention has a rising trend.5.Combined stroke/TIA patients with nonvalvular atrial fibrillation combined stroke/TIA patients with blood sugar and low density lipoprotein level,left ventricular ejection fraction and BMI significantly difference?P < 0.05?,and triglyceride,total cholesterol,left atrial diameter in patients with no significant difference?P > 0.05?.Results showed that the merger of poor control of blood glucose levels in patients with stroke,low density lipoprotein levels and reduced left ventricular ejection fraction and higher BMI higher percentage.Conclusions:1.CHADS₂ compared with CHA₂DS₂-VASc score,can effectively filter out patients at high risk of stroke,CHA₂DS₂-VASc score in patients at high risk of stroke/TIA screened several more,have a higher risk of stroke patients HAS-BLED bleeding risk is higher.2.Based on the CHADS₂ score high,moderate stroke patients with nonvalvular atrial fibrillation of low proportion of anticoagulant intervention,antiplatelet aggregation intervention is higher,anticoagulant intervention proportion of 2014 ²016 is on the rise.3.Female,older age,poor control of diabetes mellitus,low density lipoprotein levels and reduced left ventricular ejection fraction and higher BMI can be risk factors for stroke patients with nonvalvular atrial fibrillation.