Retrospective Analysis Of Risk Factors And Pathogenesis In Ischemic Stroke With Non-Valvular Atrial Fibrillation

ObjectivesTo investigate the risk factors and the possible pathogenesis of the ischemic stroke patients with non-valvular atrial fibrillation(NVAF)by compare carotid intima-media thickness?the number and nature of plaque in ischemic stroke patients with NVAF and hypertension and those only with hypertension.MethodsIn this retrospective analysis,we screened 103 confirmed cases of acute ischemic stroke patients with NVAF and Hypertension(call NVAF group for short)and 145 cases of acute ischemic stroke patients with Hypertension[call non atrial fibrillation(NAF)group for short] within nearly 4-year from September 1,2009 to June 17,2013 in Department of Neurology of The First Affiliated Hospital of Fujian Medical University(age?50).We made a comparison of age types between the two groups(age?80;age>80),and each type of the two groups between Gender?the History(Smoking?Drinking?Hypertension?Diabetes Mellitus?Hemorrhagic Transformation of Cerebral Infarcts or not);Blood Pressure(Systolic Blood Pressure?Diastolic Blood Pressure?Pulse Pressure);laboratory tests including Total Cholesterol(TCHO),Low Density Lipoprotein(LDL-C),Serum Uric Acid(SUA)? Fibrinogen(Fib)?Carotid Intima-Media Thickness Average((?))?Carotid Plaque Incident Rate(Normal?Single Stable Plaque?Single Unstable Plaque?Multiple Stable Plaque?Multiple Unstable Plaque)ResultsIn first type(Age?80),The results showed that Systolic Blood Pressure?Pulse Pressure? (?) in the NVAF group are higher than in the NAF group(P: 0.007?0.003?0.008).Incidence Rate of Multiple Unstable Plaque in the NVAF group is higher than the rate in NAF group(P=0.019).The Incident Rate of Hemorrhagic Transformation of Cerebral Infarcts in the NVAF group is higher than the rate in NAF group(P=0.000).There was no significant difference found in gender?history of Drinking?Smoking?Diabetes Mellitus?TCHO?LDL-C?Fib?Diastolic Blood Pressure?Incidence rate of Plaque(Normal?Single Stable Plaque?Single Unstable Plaque?Multiple Stable Plaque)(P>0.05).In second type(age>80),only Incidence Rate of Single Stable Plaque in the NAF group is higher than in the NVAF group(P=0.035),other statistical data has no significance.ConclusionSystolic Blood Pressure?Pulse Pressure are postively correlated with Carotid Intima-Media Thickness.Non-Valvular Atrial Fibrillation may increase the Incidence Rate of Multiple Unstable Plaque,and pathogenesis in ischemic stroke with Non-Valvular Atrial Fibrillation may because Multiple Stable Plaque detached embolize cerebral artery exclude cardiogenic embolism.Non-Valvular Atrial Fibrillation is one of risk factors for hemorrhagic transformation of cerebral infarcts.