The Predictive Value Of CHA₂DS₂-VASc Score And Homocysteine For The Incidence Of Thrombotic Events In Patients With Non-valvular Atrial Fibrillation

?Objective:?To discuss the predictive value of CHA₂DS₂-VASc score and homocysteine for the incidence of thrombotic events in patients with non-valvular atrial fibrillation.?Methods?228 patients with nonvalvular atrial fibrillation were selected and divided into the thrombosis group?n=146?and non thrombosis group?n=82?.The patients'clinical basic information,and biochemical makers,the serum homocysteine concentration and CHA₂DS₂-VAScscorewerecollectedanddetected.The CHA₂DS₂-VASc score and serum homocysteine level were compared between the two groups.The predictive accuracy of combination of CHA₂DS₂-VASc score and serum homocysteine level for thrombosis events were analyzed by Logistic regression analysis and ROC curve.?Results?Compared with the non-thrombosis group,the CHA₂DS₂-VASc score,homocysteine,D-Ddimer,fibrinogen and low density lipoprotein levels were higher in the thrombosis group.Logistic regression analysis showed that CHA₂DS₂-VASc score?2points,homocysteine>15.0?mol/L were independent risk factors for thrombosis in the patients with non-valvular atrial fibrillation?P<0.05?.ROC curve showed that the area under the curve of CHA2DS2-VASc score and homocysteine were 0.752?95%CI:0.654-0.762?and0.797?95%CI:0.709-0.825?respectively.The area under the curve to of CHA₂DS₂-VASc score combined with homocysteine to predict the thrombosis events in the patients with non-valvular atrial fibrillation was 0.869?95%CI:0.827-0.918?,which was significantly higher than CHA₂DS₂-VASc score and homocysteine alone?P<e0.05?.And the best point to predict thrombosis events was CHA₂DS₂-VASc score?2points and homocysteine>10.2?mol/l in this study.?Conclusion:?Both CHA₂DS₂-VASc score and homocysteine levels had high predictive value for the thrombus.The patients with the CHA2DS2-VASc score?2 and high homocysteine level were extremely high risk of thromboembolic events occurred in non valvular atrial fibrillation.