Correlation Between Platelet Indexes And Left Atrial Appendage Thrombosis In Patients With Non Valvular Atrial Fibrillation

Objective:To explore the correlation and clinical significance of platelet count(PLT),platelet volume distribution width(MPV),mean platelet volume(PDW),platelet / lymphocyte ratio(PLR)and left atrial appendage thrombosis in patients with non-valvular atrial fibrillation(NVAF).Methods:According to the inclusion and exclusion criteria,562 NVAF patients who were hospitalized in the Department of Cardiovascular Medicine of Second Hospital of Shanxi Medical University and Shanxi Bethune Hospital from January 2020 to December 2022 were selected,and the clinical data of the patients were collected,including:(1)General clinical data: age;sex;BMI;smoking history;drinking history;CHA2DS2-VASc score;(2)Laboratory test index:Platelet related indexes: PLT、 PDW、MPV、 PLR;Blood coagulation related indexes:Prothrombin time(PT),activated partial thromboplastin time(APTT);Blood lipid related index:total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C).(3)Echocardiographic data: left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),Left Ventricular shortening Fraction(LVFS).(4)incidence of complications: diabetes,coronary atherosclerotic heart disease,hypertension,heart failure.1.Patients were divided into the NVAF group with LAATM and the NVAF group without LAATM according to whether they were combined with LAATM,and the general data,laboratory examination indicators,differences in echocardiographic values,and the incidence of complications were compared between the two groups.2.Taking the occurrence of LAATM in patients with NVAF as a dependent variable,Logistic regression analysis was carried out on the risk factors of LAATM in patients with NVAF.3.The ROC curve and AUC were used to evaluate the efficacy of MPV and PLR in predicting LAATM in patients with NVAF.Results:This study included 562 patients with nonvalvular atrial fibrillation.Compared with the group without LAATM,the LAATM group had significantly higher diabetes ratio,heart failure ratio,MPV level,PLR level,LDL-C level,LAD size,CHA2DS2-VASc score,and significantly lower HDL-C level and LVEF size,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that MPV and PLR were independent risk factors for LAATM formation in NVAF patients(MPV,OR=2.625,95% CI: 1.868-3.690,P<0.001;PLR,OR=1.029,95% CI: 1.015-1.043,P<0.001).AUC in the ROC curve of MPV is 0.709(95% CI: 0.642-0.775,P<0.001);AUC in ROC curve of PLR is 0.659(95% CI:0.587-0.731,P < 0.001)。Conclusion:In patients with nonvalvular atrial fibrillation,mean platelet volume and platelet-to-lymphocyte ratio are independently associated with LAATM,mean platelet volume and platelet-to-lymphocyte ratio may be participating factors in the occurrence of LAATM.