Relationship Between Atrial Fibrillation,CHADS₂ Score And Ischemic Stroke In Patients With Coronary Artery Disease

Objective: The purpose of this study was to investigate the relationship between atrial fibrillation?AF?,CHADS₂ score and ischemic stroke in patients with coronary artery disease.Methods:A total of 2335 patients with coronary artery disease were included.They were divided into no ischemic stroke group?n=1997?and ischemic stroke group?n=388?according to whether they had an ischemic stroke or not.Propensity score matching was used to match ischemic stroke patients with no ischemic stroke patients in a 1:4 ratio.In the matched data,the baseline data of the two groups were compared according to whether they had AF or not.The relationship between AF,CHADS₂ score and ischemic stroke was evaluated using a univariate generalized linear model in different age,body mass index and coronary artery disease subgroups.Univariate and multivariate generalized linear models were used to evaluate the relationship between AF,CHADS₂ score and ischemic stroke in different models.Results: Before matching,CHADS₂ score was higher in the ischemic stroke group compared with the no ischemic stroke group?3.00 vs 1.00,P<0.001?,while the proportion of AF was not significantly different.In the matched data,the AF group had a higher CHADS₂ score compared with the no AF group?2.00 vs 1.00,P<0.001?,while there was no significant difference in the proportion of ischemic stroke patients between the two groups.Subgroup analysis showed that paroxysmal AF was not associated with ischemic stroke in each subgroup,compared with the absence of AF.Compared with the absence of AF,non-paroxysmal AF was associated with ischemic stroke in males,60-79 years old,overweight subgroups,as well as in those subgroups without unstable angina,without non-ST-segment elevation myocardial infarction,without ST-segment elevation myocardial infarction,and without prior myocardial infarction subgroups?P<0.05?.In CHADS₂ score ?2 subgroup,paroxysmal AF and non-paroxysmal AF were not associated with ischemic stroke compared with the absence of AF.CHADS₂ score was associated with ischemic stroke in all subgroups except the 20-39 years old and the lean subgroup?P<0.05?.Multivariate analysis showed that paroxysmal and non-paroxysmal AF was not associated with ischemic stroke compared with the absence of AF.In different models,the CHADS₂ score was associated with ischemic stroke?P<0.05?.Conclusion:After adjusting for confounding factors,the correlation between AF and ischemic stroke decreases,while the CHADS₂ score is consistently correlated with ischemic stroke.