Analysis of factors related to systemic embolism in patients≥75 years old with non-valvular atrial fibrillation
10.3760/cma.j.cn112138-20220130-00087
- VernacularTitle:大于等于75岁非瓣膜性心房颤动患者发生体循环栓塞相关因素分析
- Author:
Yaping YU
1
;
Yuwei FENG
;
Xiaoxue ZHANG
;
Meng WEI
;
Yanmei LU
;
Qiang XING
;
Jianghua ZHANG
;
Yaodong LI
;
Baopeng TANG
;
Xianhui ZHOU
Author Information
1. 新疆医科大学第一附属医院心脏中心起搏电生理科, 乌鲁木齐 830054
- Keywords:
Aged;
Atrial fibrillation;
Embolism
- From:
Chinese Journal of Internal Medicine
2023;62(2):156-162
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the related risk factors for systemic embolism (SE) in patients aged≥75 years with non-valvular atrial fibrillation (NVAF).Methods:A case-control study. NVAF patients aged≥75 years who were hospitalized at the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2020 were divided into no SE ( n=1 127) and SE ( n=433) groups according to the occurrence of SE after NVAF. Multivariate logistic regression was used to analyze SE-related factors in patients with NVAF without anticoagulation treatment. Results:In the multivariate model, the following factors were associated with an increased risk of SE in patients with NVAF: history of AF≥5 years [odds ratio ( OR)=2.75, 95% confidence interval ( CI) 1.98-3.82, P<0.01], lipoprotein(a)>300 g/L ( OR=2.07, 95% CI 1.50-2.84, P<0.01), apolipoprotein (Apo)B>1.2 g/L ( OR=1.91, 95% CI 1.25-2.93, P=0.003), left ventricular ejection fraction (LVEF) of 30%-49% ( OR=2.45, 95% CI 1.63-3.69, P<0.01), left atrial diameter>40 mm ( OR=1.54, 95% CI 1.16-2.07, P=0.003), and CHA 2DS 2-VASc score≥3 ( OR=15.14, 95% CI 2.05-112.13, P=0.01). ApoAI>1.6 g/L was negatively correlated with the occurrence of SE ( OR=0.28, 95% CI 0.15-0.51, P<0.01). Conclusions:History of AF≥5 years, lipoprotein(a)>300 g/L, elevated ApoB, left atrial diameter>40 mm, LVEF of 30%-49%, and CHA 2DS 2-VASC score≥3 are independent risk factors for SE whereas ApoAI>1.6 g/L is a protective factor against SE in patients with NVAF.
