Retrospective Study Of Rivaroxaban In Prevention Of Stroke In Non-vavular Atrial Fibrillation

BackgroundPatients with atrial fibrillation are often older and have more underlying diseases,such as valvular heart disease,hypertension,coronary heart disease,cardiac insufficiency,diabetes,and so on,so that the risk of stroke is much higher than normal people.Anticoagulant therapy in patients with atrial fibrillation is the most critical link in the prevention of stroke.Therefore,an accurate and effective stroke risk assessment has guiding significance for the selection of anticoagulant drugs in patients with atrial fibrillation.Currently,the CHADS2 score and the CHA2DS2-VASC score are often used internationally to assess stroke risk in patients with atrial fibrillation.In recent years,studies have found that a variety of biomarkers that can reflect cardiac and renal dysfunction are associated with stroke risk in patients with atrial fibrillation,and both stroke scores consider only clinical factors.The inclusion of biomarkers in the stroke scoring system may provide more benefit to AF patients.The risk stratification of patients based on more comprehensive baseline characteristics is the basis for formulating a correct anticoagulant treatment strategy.Anticoagulant therapy is the key to prevention of ischemic stroke in patients with atrial fibrillation.Rivaroxaban,the world's first oral direct factor Xa inhibitor,is a new type of anticoagulant drug.In China,there are few studies on the prevention of stroke in non-valvular atrial fibrillation.Therefore,this study evaluated the safety of warfarin compared with the classic anticoagulant drug in the Chinese population,providing stronger evidence for clinical application.AimThis study compared the risk of stroke in patients with atrial fibrillation using the ABC rule and the traditional scoring method.Through this method of stratification and the use of prophylactic drugs,biomarkers were included in the stroke scoring system to provide more benefits to patients with atrial fibrillation and achieved good clinical results.At the same time,by observing the change of coagulation function index after taking rivaroxaban in patients with NVAF,the safety of anticoagulation with rivaroxaban was explored.MethodStroke risk stratification was derived from the NVAF score,and stroke risk assessment wasperformed in patients with atrial fibrillation based on the score change analysis.Patients with NVAF were recruited and used a variety of statistical analysis methods to compare their anticoagulant safety indicators with rivaroxaban and warfarin.Result(1)The impact of various scoring items(Medical history,age,c Tn I,NT-pro BNP)on the risk assessment of stroke in the ABC scoring system.The difference in the history of prior stroke/TIA between the non-stroke group and the stroke group was found to be statistically significant(P = 0.029);age can increase the risk of stroke.The remaining differences were statistically significant(P < 0.05).The biomarker troponin c Tn I is an important marker of cardiovascular disease,with a mean of 17.6±5.8 ?g/L in the non-stroke group and 23.1±7.7 ?g/L in the stroke group,with a statistically significant difference(P = 0.001),further divided c Tn I into three groups and found significant differences between the groups(P = 0.028).NT-pro BNP was further divided into three groups and found significant differences between groups(P = 0.003).(2)Compared with the warfarin group,the incidence of new thromboembolic events(cerebral thrombosis,systemic thromboembolism)was significantly lower in the rivaroxaban group than in the warfarin group(P<0.05).There were more blood events in the warfarin group than in the rivaroxaban group.The difference was statistically significant(P<0.05),and the rivaroxaban group also had an advantage in patients with moderate renal insufficiency.The difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.(P>0.05)Conclusion(1)The ABC score is comparable to the CHA2DS2-VASC score in the detection of atrial fibrillation stroke and is superior to the CHADS2 score.The ABC score was superior to the CHA2DS2 score for stratification in low-to-moderate-risk patients.It is suggested that the ABC stroke score is better than the CHADS2 score in assessing the risk of stroke in patients with non-valvular atrial fibrillation.It is applicable to stroke risk assessment in patients with nonvalvular atrial fibrillation in China.(2)Confirming a novel oral anticoagulant,rivaroxaban,by analyzing new thromboembolic events,newly elicited blood events,and use in patients with moderate renal insufficiency after taking rivaroxaban in NVAF patients.The application in Chinese population is not inferior to the strict control of warfarin,which significantly reduces the bleeding,and it also has advantages in patients with moderate renal insufficiency..