Risk Factors For Ischemic Stroke In Patients With Non-Valvular Artial Fibrillation

Objective: 1.To analyze the difference of clinical data between the simple Atrial Fibrillation?AF?group and the combined ischemic stroke?IS?group in patients with Non-valvular Atrial Fibrillation?NVAF?.2.Through analyzing the patient's general data,the laboratory test target and the imagine examinations,the risk factors of increased stroke risk caused by NVAF were identified,they can be used as a supplement of the CHA₂DS₂-VASc score to better assess the risk of stroke,then provide the basis for early prevention and anticoagulation therapy.Methods: 1.Collecting the date of patients with NVAF who were admitted to the department of cardiology and neurology of Liaoning provincial people's hospital on September,2016 and September,2018.Cases were screened according to inclusion and exclusion criteria,and a total of 396 cases were selected,280 patients without IS in the single AF group and 116 patients with IS were divided into the IS group.2.To Record the patient's information including age,gender,smoking history and combined disease?congestive heart failure,hypertension,diabetes,and stroke/Transient Ischemic Attacks?TIA?/history of thrombosis,vascular lesions,etc.?,and whether oral aspirin and warfarin or not,then calculate the corresponding CHADS₂ score and CHA₂DS₂-VASc score,record the laboratory test target within 48 hours after admission,including platelet count,D-2 polymers,fibrinogen,blood lipid,renal function,uric acid and urea nitrogen and N-terminal pro-brain Natriuretic Peptide?NT-pro BNP?and the image examinations: ultrasonic cardiogram.3.The risk factors for IS in patients with NVAF were analyzed by Spearman correlation analysis and multivariate logistic regression analysis.Result: 1.Comparison of general clinical data between the two groups:There were significant differences in age between the two groups,the number of IS associated with AF increased with age,patients aged 75 years or older accounted for the highest proportion,about 71%.The ages of patients in the AF group and the IS group were?66.04±12.31?years and?77.16±7.78?years,respectively,the difference was statistically significant?p<0.05?.CHADS₂ and CHA₂DS₂-VASc score were compared between the two groups,and the differences were statistically significant?p<0.05?.There were no significant difference in smoking,gender,aspirin or warfarin use.?p>0.05?.2.Urea nitrogen,uric acid,NT-pro BNP and the size of left atrium diameter?LAD?were higher in the IS group,and the difference was statistically significant?p<0.05?.3.Spearman Correlation Analysis showed that NVAF combined with stroke was positively correlated with age,CHADS₂ score,CHA₂DS₂-VASc score,urea nitrogen,uric acid and NT-pro BNP.4.The above risk factors were analyzed by multivariate logistic regression analysis.The results showed that: CHADS₂ score,CHA₂DS₂-VASc score,NT-pro BNP and the size of LAD were independent risk factors of stroke in patients with NVAF?p<0.05?.Conclusion: In addition to CHADS₂ score and CHA₂DS₂-VASc score can predict the risk of stroke in NVAF,NT-pro BNP and the size of LAD are also independent risk factors of stroke in patients with NVAF?p<0.05?,which can be used as simple and easy indicators,combined with CHADS₂ score and CHA₂DS₂-VASc score,to better assess the risk of stroke.