不同评分系统对非瓣膜性心房颤动患者左心耳血栓状态的预测效果研究OACSTPCD

Objective To investigate the differences in different scoring systems in predicting left atrial appendage thrombotic status(LAATM)in the patients with nonvalvular atrial fibrillation(NVAF).Methods The NVAF inpatients with transesophageal echocardiography(TEE)treated in this hospital from January 1,2015 to December 31,2020 were selected as the study subjects and divided into the LAATM group and non-LAATM group according to the TEE results.The general data of the patients were collected,inclu-ding the sex,age,complicating disease,etc.All patients conducted the scoring by the CHA2DS2-VASc score,CHA2DS2-VASc-RAF score,CHA2DS2-VASc-60 score and ABC stroke score.The predictive value of different scoring systems on LAATM was analyzed.Results A total of 1 217 patients with NVAF were enrolled in this study,including 647 males and 570 females.There were 529 cases of persistent atrial fibrillation,688 cases of paroxysmal atrial fibrillation,TEE showed 112 cases of LAATM and 1 105 cases of non-LAATM.The age,in-cidence of persistent atrial fibrillation,incidence of smoking,incidence of diabetes,incidence of coronary heart disease,incidence of stroke/TIA,incidence of statin,N terminal pro-B type natriuretic peptide(NT-proBNP)and estimated glomerular filtration rate(eGFR)in the LAATM group were higher than those in the non-LAATM group,and the differences were statistically significant(P＜0.05).In 4 kinds of scoring systems,the LATTM detection rate in the population with high risk scores was the highest.The area under the ROC curve of the ABC stroke score(0.826)was higher than that in the other scores(0.741,0.688,0.658),and the differences were statistically significant(P＜0.05).In the patients with persistent atrial fibrillation,the area under the ROC curve of ABC stroke score(0.836)was higher than that of the other three scores(0.793,0.763,0.724,P＜0.05),and in the patients with paroxysmal atrial fibrillation,the area under the ROC curve of ABC stroke score(0.764)was higher than that of the other three scores(0.742,0.686,0.635),and the differences were statistically significant(P＜0.05).Conclusion CHA2DS2-VASc score,CHA2DS2-VASc-RAF score,CHA2 DS2-VASc-60 score and ABC stroke score all have certain predictive value for LAATM,in which the predictive value of ABC stroke score is higher than that of the other three scores.