Predictive value of a nomogram model based on clinical risk factors for ischemic stroke in patients with atrial fibrillation
10.3969/j.issn.1009-0126.2025.09.025
- VernacularTitle:基于临床危险因素的列线图模型对心房颤动并发缺血性脑卒中的预测价值
- Author:
Xiaohui WEI
1
;
Yi ZHANG
;
Xiaoyun LI
;
Li SONG
Author Information
1. 257091 东营市人民医院(山东省立医院集团东营医院)保健科
- Publication Type:Journal Article
- Keywords:
atrial fibrillation;
ischemic stroke;
risk factors;
forecasting
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(9):1246-1251
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors for ischemic stroke in patients with atrial fibrilla-tion(AF)and construct a prediction model.Methods A retrospective study was conducted on 253 AF patients treated at our hospital from January 2021 to December 2024.They were randomly divided into a modeling group(n=177)and a validation group(n=76)in a 7∶3 ratio.The model-ing group was further divided into a simple AF subgroup(96 cases)and a stroke subgroup(81 cases)based on the occurrence of ischemic stroke.Clinical data were collected,including low-density lipoprotein cholesterol,red cell distribution width(RDW),D-dimer,fibrinogen,N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-sensitivity cardiac troponin I(hs-cTnI),etc.Univariate and multivariate logistic regression analyses were performed to identify risk factors for ischemic stroke,and a nomogram model was constructed.The predictive performance of the model was evaluated using ROC curve analysis,calibration curve analysis,and decision curve analysis(DCA).Results Multivariate logistic regression analysis indicated that left atrial diameter(OR=1.205,95％CI:1.046-1.388,P=0.010),RDW(OR=1.605,95％CI:1.138-2.263,P=0.007),D-dimer(OR=2.633,95％CI:1.229-5.640,P=0.013),fibrinogen(OR=3.053,95％CI:1.312-7.108,P=0.010),NT-proBNP(OR=1.005,95％CI:1.003-1.007,P=0.001),and hs-cTnI(OR=1.129,95％CI:1.046-1.218,P=0.002)were independent risk factors for ischemic stroke in AF patients.ROC curve analysis showed an AUC value of 0.926(95％CI:0.885-0.967)for the modeling group and 0.912(95％CI:0.847-0.978)for the validation group.H-L test showed Chi-square=8.005,P=0.433 for the modeling group and Chi-square=2.590,P=0.957 for the validation group.DC A demonstrated high practical value for the model.Conclusion The nomo-gram model constructed in the study has good predictive performance and clinical utility.
