Objective To explore the risk factors for futile recanalization after mechanical throm-bectomy for acute large vessel occlusion(LVO)in elderly patients with atrial fibrillation(AF),and construct a prediction model.Methods A total of 146 elderly AF patients who undergoing mechanical thrombectomy due to LVO and achieved successful recanalization(modified thromb-olysis in cerebral infarction,mTICI≥2b)in our hospital from January 2018 to July 2023 were consecutively recruited in this retrospective analysis.According to the 90-day clinical outcome,they were divided into a futile recanalization group(79 cases)and an effective recanalization group(67 cases).The general clinical data were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for futile recanalization,and based the factors,a nomogram for the prediction was drawn.ROC curve and calibration curve analyses were applied to evaluate the reliability of the prediction model,and decision curve analysis was conducted to assess the clinical application value.Results Multivariate logistic regression analysis identified that baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombec-tomy≥3 attempts were independent risk factors for futile recanalization(OR=1.395,95％CI:1.174-1.658,P=0.000;OR=1.001,95％CI:1.000-1.001,P=0.003;OR=8.024,95％CI:2.554-25.204,P=0.000;OR=5.056,95％CI:1.778-14.375,P=0.002).The AUC value of the prediction model was 0.868(95％CI:0.808-0.929).Calibration curve analysis showed that the model obtained consistent predicted probability with actual probability,and decision curve analy-sis indicated that the model had good clinical benefit.Conclusion Baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombectomy≥3 attempts are independent risk factors for futile recanalization after mechanical thrombectomy in elderly AF patients.Our prediction model has good predictive performance and prediction accuracy,but its application still needs prospective research and external verification.

Objective To explore the risk factors for futile recanalization after mechanical throm-bectomy for acute large vessel occlusion(LVO)in elderly patients with atrial fibrillation(AF),and construct a prediction model.Methods A total of 146 elderly AF patients who undergoing mechanical thrombectomy due to LVO and achieved successful recanalization(modified thromb-olysis in cerebral infarction,mTICI≥2b)in our hospital from January 2018 to July 2023 were consecutively recruited in this retrospective analysis.According to the 90-day clinical outcome,they were divided into a futile recanalization group(79 cases)and an effective recanalization group(67 cases).The general clinical data were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for futile recanalization,and based the factors,a nomogram for the prediction was drawn.ROC curve and calibration curve analyses were applied to evaluate the reliability of the prediction model,and decision curve analysis was conducted to assess the clinical application value.Results Multivariate logistic regression analysis identified that baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombec-tomy≥3 attempts were independent risk factors for futile recanalization(OR=1.395,95％CI:1.174-1.658,P=0.000;OR=1.001,95％CI:1.000-1.001,P=0.003;OR=8.024,95％CI:2.554-25.204,P=0.000;OR=5.056,95％CI:1.778-14.375,P=0.002).The AUC value of the prediction model was 0.868(95％CI:0.808-0.929).Calibration curve analysis showed that the model obtained consistent predicted probability with actual probability,and decision curve analy-sis indicated that the model had good clinical benefit.Conclusion Baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombectomy≥3 attempts are independent risk factors for futile recanalization after mechanical thrombectomy in elderly AF patients.Our prediction model has good predictive performance and prediction accuracy,but its application still needs prospective research and external verification.

Objective To investigate the clinical characteristics, TCM syndrome differen tiation and short_term prognosis of painless acute myocardiac infarction (AMI). Methods Restrospective analysis was carried out in 32 patients with painless AMI (Group A) and 30 cases of painful AMI in the same period served as Group B. Results In Group A, clinical manifestations were latent, infarct places mai nly located in the inferior wall, right ventricle and posterior wall of the hear t ( 65.6% ), and yang_Qi deficiency syndrome and Qi_yin defic iency syndrome occupied 65.6% of painless AMI. Blood stasis syn drome and phlegm syndrome occupied 70.0% of painful AMI. The co ncurrent incidence of diabetes mellitus was higher in Group A than Group B. So d id the mortality and the incidence of heart failure. Cardiogenic shock and heart failure were the main death causes of painless AMI. Conclusion The above r esults will supply evidence for the combined treatment of painless AMI.