The Value Of Thrombelastogram In Evaluating Cases Of Non-valvular Atrial Fibrillation Intra-atrial Thrombus And Thromboembolic Stroke

Objective: The purpose of this study was to evaluate the value of thromboelastography in the assessment of atrial thrombosis and thromboembolic stroke in non valvular atrial fibrillation.Methods:1.From May 2018 to December 2019,80 inpatients with AF who were definitely diagnosed in the Department of Cardiology and neurology of People's Hospital of Liaoning Provincial and planned to undergo radiofrequency ablation were selected,including 47 males and 33 females,with an average age of 63.6 ± 10.47 years.According to the results of transesophageal ultrasound,the patients were divided into two groups: group with atrial thrombus(40 cases)and group without atrial thrombus(40 cases).According to whether or not AF related stroke occurred,the patients were divided into two groups: embolization(22 cases)and non embolization(18 cases).2.Record the patient's case information in detail,including the patient's gender,age,atrial fibrillation time,left atrial diameter,thromboelastography,coagulation function,fibrinogen,D-dimer and other related biochemical tests,and record the combined diseases,hypertension,diabetes and heart failure.Spss23.0 statistical software was used to analyze the data,and the differences between the two groups were compared.The mean and standard deviation(X ±S)were used to describe the detection indexes of each group.Single factor analysis of variance was used to compare between the two groups.Chi square test was used to test whether there was any difference in the prevalence rate between the groups with and without atrial thrombus,between the groups with and without thrombotic stroke history.P < 0.05 The difference was statistically significant.Results: 1.There was no significant difference in sex,history of hypertension,history of diabetes mellitus,history of heart failure,type of atrial fibrillation and age between the Intra-atrial Thrombus group and no Intra-atrial Thrombus group(P > 0.05).The left atrial diameter in the group with atrial thrombus was significantly higher than that in the group without atrial thrombus(45.08±6.06 mm vs.40.48±4.60 mm,P<0.001).2.There was no significant difference in APTT,PT and TT between the the Intra-atrial Thrombus group and no Intra-atrial Thrombus group(P > 0.05).Fibrinogen in the group with atrial thrombus was significantly higher than that in the group without atrial thrombus(3.24±0.87g/L vs.2.90±0.58g/L,P=0.046),the difference was statistically significant.D-dimer in the group with atrial thrombus was significantly higher than that in the group without atrial thrombus(0.49±0.21mg/L vs.0.39±0.08mg/L,P=0.007),the difference was statistically significant.3.The R value of thromboelastogram in the group with atrial thrombus was significantly lower than that in the group without atrial thrombus(4.88±0.85 min vs.5.28±0.78 min,P=0.030),the difference was statistically significant.The K value in the group with atrial thrombus was significantly lower than that in the group without atrial thrombus(1.87±0.36 min vs.2.10±0.43 min,P=0.011),the difference was statistically significant.The Angle value of the group with atrial thrombus was significantly higher than that in the group without atrial thrombus(69.87±5.31 deg vs.67.68±4.07 deg,P=0.041),the difference was statistically significant.The MA value of the group with atrial thrombus was significantly higher than that of the group without atrial thrombus(63.74±5.29 mm vs.61.27±3.83 mm,P=0.019).4.There was no significant difference in sex,history of hypertension,history of diabetes,history of heart failure,type of AF,age and left atrial size,APTT,PT,TT,D-D,FIB,TEG of R value,K value,Angle and Ma value between the the Thromboembolic stroke group and no Thromboembolic stroke group.Conclusion:1.The R value,K value,Angle and Ma value of thromboelastography are valuable in the evaluation of atrial thrombosis in patients with non valvular atrial fibrillation.2.The R value,K value,Angle and Ma value of thromboelastography have no evaluation value for the occurrence of thromboembolic stroke in patients with non valvular atrial fibrillation and atrial thrombus.