Effect Of Aspirin On Inflammatory Factors In Patients With Rheumatic Mitral Valve Disease Complicated With Persistent Atrial Fibrillation

Objective:To investigate the effect of aspirin on serum inflammatory factors and conversion of atrial fibrillation in rheumatic mitral valve disease patients with persistent atrial fibrillation(PeAF).Methods:A total of 60 patients with rheumatic mitral valve disease patients-PeAF admitted to the Affiliated Hospital of North Sichuan Medical College(Cardiology and Heart surgical department)from September 2018 to September 2020 were randomly divided into AF control group(n=30)and AF experimental group(n=30)by coin tossing method.The control group was treated with conventional medication(dieresis,anti-freezing,rate control),and the experimental group was treated with aspirin on the basis of conventional therapy.The treatment cycle was 3 months.Twenty eight patients with normal sinus rhythm(NSR)were selected as the control group.The parameters of cardiac function were measured by echocardiography,the levels of serum inflammatory factors high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and interleukin-1β(IL-1β)were detected by enzyme linked immunosorbent assay(ELISA)before and after treatment,and the changes of coagulation function were detected by coagulation analyzer.The therapeutic effect and adverse reactions of the two groups were compared.Receiver operating curve(ROC)was used to calculate area under the curve(AUC),and the predictive value of hs-CRP,IL-6 and IL-1β on the conversion of atrial fibrillation after treatmentin mitral rheumatic valve disease-PeAF.Result:(1)The levels of hs-CRP,IL-6 and IL-1β in rheumatic mitral valve disease-PeAFpatients were significantly higher than those in sinus rhythm group(P<0.05).After treatment,the levels of inflammatory factors in rheumatic mitral valve disease-PeAFpatients were significantly decreased,and the decrease in the experimental group was more significant(P<0.05).(2)After treatment,PT,APTT and TT of the two groups were significantly prolonged and FIB decreased compared with those before treatment(P<0.05),and PT,APTT and TT of the experimental group were significantly prolonged and FIB decreased compared with those of the control group(P<0.05).(3)The total effective rate of the experimental group was higher than that of the control group,but there was no significant difference(P<0.05).There was no significant difference in the incidence of vomiting and gastrointestinal bleeding between the two groups(P>0.05).(4)ROC curve analysis showed thatthe AUC of hs-CRP,IL-6 and IL-1βfor predicting the conversion of rheumatic mitral valve disease-PeAF was0.867,0.791 and 0.764,respectively.The sensitivity was 80.0%,63.3%and66.7%,and the specificity was 90.0%,86.7%and 80.0%,respectively.Conclusion:(1)Rheumatic mitral valve disease-PeAFpatients had significantly low grade inflammation,hypercoagulability and decreased cardiac function.(2)Aspirin combined with conventional treatment can reduce the level of inflammation,improve coagulation function to a certain extent in rheumatic mitral valve disease-PeAF patients.(3)The level of hs-CRP,IL-6 and IL-1β before treatment had a certain predictive value on the conversion rate of atrial fibrillation after treatment in rheumatic mitral valve disease-PeAF patients.