Analysis Of Correlative Factors On The Severity Of Neurological Impairment In The First Cerebral Infarction Caused By Non-valvular Atrial Fibrillation

Background and objective:Cerebral infarction is the most serious complication in non-valvular atrial fibrillation(NVAF)patients.Anticoagulation is an effective measure to reduce the incidence of cerebral infarction,but the severity of first cerebral infarction is not consistent in non-anticoagulant patients with non-valvular atrial fibrillation,and there must be many factors that affect the severity of cerebral infarction stroke.The main purpose of this study is to explore the relationship between the severity of first cerebral infarction and the basic data,blood routine,blood coagulation and heart-related test and examination indexes of patients with non-valvular atrial fibrillation without anticoagulant therapy.The purpose of this study is to provide a reference basis for predicting severe cerebral infarction in patients with non-valvular atrial fibrillation without cerebral infarction.Methods:A total of 107 NVAF patients with first cerebral infarction without anticoagulant therapy in The Second Affiliated Hospital of Dalian Medical University from January 2020 to October 2022 were collected.According to the National Institutes of Health Stroke scale(NIHSS),the patients were divided into two groups:light group(NIHSS score<5)and unlight group(NIHSS score≥5).The differences of basic data,blood routine,hemagglutination routine and heart-related test and examination indexes between the two groups were analyzed by relativity analysis.Correlation analysis was carried out between the different indicators and the severity of first cerebral infarction neurological deficit,and the factors related to the severity of first cerebral infarction neurological deficit were further included in the Logistic regression analysis to obtain independent affecting factors and plot receiver operator characteristic curve(ROC)to assess the accuracy of risk predictors.Results:1.There are differences in WBC,N%,NLR,TT,BNP,CK-MB and aortic valve blood flow velocity between light and unlight groups(P<0.05).There was no difference in age,hypertension,diabetes,and type of atrial fibrillation between the light group and the unlight group(P≥0.05).2.WBC,NLR,BNP,CK-MB and aortic valve blood flow velocity are associated with the severity of first cerebral infarction neurological deficit in patients with NVAF.3.WBC(OR=1.369,95%CI:1.044-1.794,P=0.023),BNP(OR=1.003,95%CI:1.001-1.005,P=0.012)and aortic valve blood flow velocity(OR=1.046,95%CI:1.015-1.078,P=0.005)are independent risk factors for the severity of first cerebral infarction neurological deficitin patients with NVAF.4.Predictive value of independent risk factors:the areas under the curve of WBC,BNP and aortic valve blood flow velocity is as follow:0.631,0.674,0.651.The sensitivity is as follows:45.5%,57.6%,87.9%.The specificity is as follows:81.1%,71.6%,41.9%.The cutoff values of WBC is 8.285×10~9/L,the cutoff values of BNP is 298.8pg/ml,the cutoff values of aortic valve blood flow velocity is108.5cm/s.5.The area under the ROC curve predicted by WBC,BNP and aortic valve blood flow velocity was 0.805,the sensitivity was 75.8%,and the specificity was 78.4%.Conclusions:1.WBC,NLR,BNP,CK-MB and aortic valve blood flow velocity were all correlated with the severity of first cerebral infarction neurological deficitin patients in NVAF patients without anticoagulant therapy.2.WBC,BNP and aortic valve blood flow velocity were all independent risk factors of the severity of first cerebral infarction neurological deficitin patients in NVAF patients without anticoagulation therapy.3.The value of WBC,BNP and aortic valve blood flow velocity in predicting the severity of first cerebral infarction neurological deficitin patients is limited.4.The combination of WBC,BNP and aortic valve blood flow velocity is of good value in predicting the severity of first cerebral infarction neurological deficitin patients.