| BackgroundNon-valvular atrial fibrillation is a common arrhythmia,stroke has a hig h disability rate,and stroke caused by atrial fibrillation is often characterized by continuous progression,even if the current treatment of atrial fibrillation a nd stroke prevention methods are quite mature,Such as anticoagulation,radiof requency ablation,and left atrial appendage occlusion,recurrence and stroke o f atrial fibrillation are still inevitable,especially in patients with per sistent atri al fibrillation,a significant prop ortion of whom are elderly patients with many chronic diseases.Itself is the high incidence of stroke,if combined with atri al fibrillation,stroke is almost inevitable.At present,the mechanism of atrial fibrillation is still unclear.although the trigger and maintenance mechanism of atrial fibrillation electrophysiology and the mechanism of pathophysiological e lectrical remodeling and structural remodeling have reached a consensus,it is still difficult to clarify the course of atrial fibrillation.Thyroid function is clo sely related to the occurrence of cardiovascular diseases.hyperthyroidism is a recognized high risk factor for atrial fibrillation and stroke cardiovascular even ts,In recent years,some studies have found that normal reference range or s ubclinical hypothyroidism will in crease cardiovascular events,but the relations hip between atrial fibrillation and atrial fibrillation is still uncertain,may be a risk factor for atrial fibrillation,the current discussion of this direction is les s,and the sample size is less.Based on this,this study analyzed the correlati on between thyroid function indexes with atrial fibrillation and atrial fibrillatio n stroke in normal reference range or subclinical hypothyroidism,and explore d the effect of thyroid function on atrial fibrillation and atrial fibrillation stro ke.ObjectiveTo analyze the relationship between thyroid function and related factors a nd atrial fibrillation,and to explore the related factors that may predict the oc currence of atrial fibrillation.To evaluate the correlation between thyroid function and atrial fibrillation stroke,and to explore the related factors affecting the occurrence of atrial fi brillation stroke.MethodTo screen and collect the clinical data of patients with normal thyroid fu nction or subclinical hypothyroidism who were treated and hospitalized in dep artment of cardiovascular medicine of NanFang Hospital from January 2017 to December 2018,and the clinical data of 557 patients with normal reference range or subclinical hypothyroidism were selected and collected.The laborator y examination,ultrasound,electrocardiogram and cranial CT information includ ing thyroid function in dexes were extracted.The collected data were analyzed by spss23 cluster analysis.in the first part,the related factors between thyroi d function indexes an d non-valvular atrial fibrillation were analyzed.the relate d clinical indexes and complications of patients with different cardiac rhythm types were compared by grouping.The correlation was verified by regression curve.the second part discussed the correlation between thyroid function inde xes and non-valvular atrial fibrillation stroke,and the related factors of atrial fibrillation stroke were analyzed by univariate and multivariate Logistic analysi s.ResultThe first part included 557 patients with thyroid function or subclinical h ypothyroidism within the normal reference range,the ratio of male to female was 1.08:1,and th e proportion of patients with non-atrial fibrillation and atrial fibrillation was 1.39:1.the clinical data of all patients were compared.Univa-riate analysis suggested that in the AF group,The proportion of male,arteria 1 plaque,stroke and heart failure patients was significantly higher than that of non-atrial fibrillation patients(P<0.05).Age,height,weight,BMI,RDW-SD,NT-proBNP,APTT,PT,D-dimer,Fbg-c,Cr,UA,FT4,LA and CHA2DS2-VA Sc scores in AF group were higher than those in non-atrial fibrillation group.PLT,ALB,CCrE,CHOL,HDL-c,LDL-c were lower than those in non-atrial fibrillation group(P<0.05),and LYM(.P=0.05)could not clearly reflect the rel ationship between the two groups because of the number of samples.Multivar iate Logistics analysis showed age(OR=1.081,95%CI:1.016-1.149,P=0.013),drinking history(OR=0.106,95%CI:0.024-0.462,P=0.003),APTT(OR=1.186,95%CI:1.062-1.325,P=0.003)、FT4(OR=1.272a,95%CI:1.399-88.552,P=0.023)、LA(OR=1.285,95%CI:1.147-1.440,P<0.001)、CH A2DS2-VASc score(OR=0.560,95%CI:0.340-0.920,P=0.022)and stroke(OR=53.571,95%CI:7.642-375.561,P<0.001)were independent risk factors and predictors of non-valvular atrial fibrillation.The second part included 233 patients with atrial fibrillation with thyroid function or subclinical hypothyroidism within the normal reference range,the ratio of male to female was 1.95:1,and the proportion of non-stroke and str oke patients was 1.99:1.Univariate analysis showed that the proportion of pat ients with coronary heart disease,arterial plaques and heart failure in atrial fi brillation stroke group was higher than that in non-stroke group.Age,RDW-S D,PT,plasma D-dimer(D-dimer),NT-proBNP and CHA2DS2-VASc scores w ere significantly higher than those in non-stroke group.The body weight,AL B,CCrE,TG,LDL-c,T3,EF in the non-stroke group were signifieantly lowe r than those in the non-stroke group.(P<0.05).Multivariate an alysis showed body weight(OR=0.956,95%CI:0.919-0.995,P=0.026)、PT(OR=1.347,95%CI:1.141-1.590,P<0.001)、T3(OR=0.7441,95%CI:0.006-0.443,P=0.007)、EF(OR=0.873,95%CI:0.826-0.923,P<0.001)、TG(OR=0.492,95%CI:0.243-0.997,P=0.049)may be an independent risk and predictor of stro ke in patients with non-valvular atrial fibrillation.Conclusion1.High levels of free thyroxine(FT4)in people with normal reference range or subclin ical hypothyroidism is an independent risk factors and predictors of non-valvular atrial fibrillation.2.Low serum triiodothyronine(T3)in people with normal reference range or subclinical hypothyroidism is an independent risk and predictor of non-valv ular atrial fibrillation stroke. |
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