| BackgroundAtrial fibrillation(AF),which is characterized by a rapid?disorderly and severe atrial electrical activity disorder,is one of the most common arrhythmia in clinical practice.It not only affects the incidence and mortality of cardiovascular disease,but also increases the risk of hospitalization complications in patients.Another problem in modern medicine is the poor prognosis of diseases caused by overweight or underweight in the disorder of nutritional status.Both in developed and developing countries,nutritional abnormalities and atrial fibrillation are the most common challenges in health care today.In recent years,the relationship between nutritional status and prognosis of patients with cardiovascular diseases has garnered increasing research interest.As a simple and comprehensive tool for assessing the nutritional status of the body,the nutritional controlling status score(CONUT score),which is mainly calculated from three parameters:serum albumin,serum total cholesterol and peripheral blood total lymphocyte count,it's prognostic value of patients with hypertension,malignant tumors and acute ischemic stroke has been reported,but the correlation between CONUT score and the incidence of atrial fibrillation has unclearObjectTo Explore the relationship between the Controlling Nutritional status score(CONUT score)and the incidence of non-valvular atrial fibrillation and assess the predictive value of the CONUT score in predicting the occurrence non-valvular atrial fibrillation,further providing references for early detection,early prevention and early treatment of atrial fibrillation in clinical work.Method1.165 cases of atrial fibrillation was selected continuously from the Department of Cardiology of Nanfang Hospital of Southern Medical University from June 2016 to June 2017 retrospectively,in which 113 males and 52 females with an average age of 66.42±11.21 years old.Select another 162 cases of non-atrial fibrillation as control from the same hospital during the same period,in which 94 males and 68 females with an average age of 58.98±11.86 years old.The clinical information of each subject were recorded in details,and assess nutritional status by CONUT score of each subject.Further,the clinical characteristics,laboratory parameters and CONUT scores between two groups were analyzed by t-test or non-parametric test,and the statistically significance between two groups were compared.In addition,logistic regression analysis was performed to determine the risk factors for atrial fibrillation.2.The subjects in the atrial fibrillation group were divided into three groups according to the duration of atrial fibrillation,including paroxysmal,persistent,and long-term persistence,the difference between the CONUT scores was compared.Then classify persistent atrial fibrillation and long-term persistent atrial fibrillation into the persistent atrial fibrillation group,and determine whether there is difference in proportion of the CONUT scores values between the paroxysmal atrial fibrillation and the persistent AF group.Results1.Compared with the control group,CONUT score,age,length of hospital stay,proportion of heart failure,BNP,CRP,Cr,UA and the proportion of malnutrition risk were significantly higher than in AF group.And lymphocyte count,albumin as well as total cholesterol were lower(P<0.05).And the proportion of CONUT score>2 in the AF group was higher than that in the control group(P<0.05).There were no significant differences in gender,admission systolic blood pressure,BMI,smoking history,white blood cells,hemoglobin,hypertension,coronary heart disease,diabetes,and cerebral infarction between two groups(P>0.05).Univariate correlation analysis suggested that the CONUT score was positively correlated with age,heart failure,and hospital stay(P<0.05).Two-variable logistic regression analysis showed that CONUT score,age,heart failure,and CRP were independent risk factors for atrial fibrillation.(OR=1.291?1.054?2.592?1.111respectively,P<0.05).For every 1 point increased in CONUT score,the risk of developing AF elevated 1.291 times correspondingly.The area under the ROC curve of the CONUT score predicting atrial fibrillation was 0.635(95%CI=0.575?0.694,P<0.001),and the optimal diagnostic cut-off value was 2 with a sensitivity of 51.5%and specificity of 66%respectively.2.The median CONUT score of the paroxysmal AF group(n = 52)was 1,2 of the persistent AF group(n = 80)and 3 of the long-term persistent AF group(n=33).The difference of CONUT score between the paroxysmal AF group and the persistent AF group,paroxysmal AF group and long-term persistent AF group have statistical significance(P<0.05;As the CONUT score increased,an elevation in the proportion of persistent atrial fibrillation accordingly.Conclusion1.The nutritional status assessed by the CONUT score is closely related to the occurrence of atrial fibrillation,which may be a risk factor for non-valvular atrial fibrillation.2.The CONUT score was likely associated with the course of atrial fibrillation,persistent atrial fibrillation group was significantly higher than that of the paroxysmal atrial fibrillation group. |
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