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非瓣膜性心房颤动患者 CHA2DS2-VASc 评分与颈动脉斑块的相关性。

The association of CHA2DS2-VASc score and carotid plaque in patients with non-valvular atrial fibrillation.

机构信息

Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

出版信息

PLoS One. 2019 Feb 8;14(2):e0210945. doi: 10.1371/journal.pone.0210945. eCollection 2019.

Abstract

OBJECTIVE

The aim of this study was to assess the association between CHA2DS2-VASc score and carotid plaques in patients with non-valvular atrial fibrillation (NVAF).

METHODS

We conducted a retrospective study including 3,435 NVAF patients who underwent carotid ultrasound examinations from January 2015 to December 2017.We collected the clinical data on the medical records system. Chi-square trend test was used to analyze trends between the prevalence of carotid plaques with an increasing CHA2DS2-VASc score. Univariate and multivariate logistic regression was also used to assess the association between carotid plaques and CHA2DS2-VASc scores. The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the optimal cutoff points of different CHA2DS2-VASc scores in NVAF patients.

RESULTS

NVAF patients with carotid plaques had higher CHA2DS2-VASc scores compared with patients who did not have carotid plaques (3.01±1.36 vs. 2.55±1.28, P < 0.05). In all participants, male participants and female participants, the prevalence of carotid plaques increased significantly as the CHA2DS2-VASc score increased (P for trend < 0.001). Multivariate logistic regression analysis demonstrated that for each 1-point increase in the CHA2DS2-VASc score, there was an associated 37% increase in the prevalence of carotid plaques. ROC curve analysis revealed that a CHA2DS2-VASc score ≥ 2 in male patients (sensitivity, 44.67%; specificity, 75.64%; AUC, 0.639) or ≥ 3 in female patients (sensitivity, 47.24%; specificity, 72.40%; AUC, 0.634) were associated with carotid plaques.

CONCLUSION

The prevalence of carotid plaques in patients with NVAF was associated with the CHA2DS2-VASc score.

摘要

目的

本研究旨在评估 CHA2DS2-VASc 评分与非瓣膜性心房颤动(NVAF)患者颈动脉斑块之间的关系。

方法

我们进行了一项回顾性研究,纳入了 2015 年 1 月至 2017 年 12 月期间接受颈动脉超声检查的 3435 例 NVAF 患者。我们从病历系统中收集了临床数据。卡方趋势检验用于分析随着 CHA2DS2-VASc 评分的增加,颈动脉斑块的患病率趋势。单因素和多因素逻辑回归也用于评估颈动脉斑块与 CHA2DS2-VASc 评分之间的关系。接收者操作特征(ROC)曲线下面积(AUC)用于确定不同 CHA2DS2-VASc 评分在 NVAF 患者中的最佳截断点。

结果

与无颈动脉斑块的患者相比,有颈动脉斑块的 NVAF 患者的 CHA2DS2-VASc 评分更高(3.01±1.36 与 2.55±1.28,P<0.05)。在所有参与者中,男性参与者和女性参与者中,随着 CHA2DS2-VASc 评分的增加,颈动脉斑块的患病率显著增加(趋势 P<0.001)。多因素逻辑回归分析表明,CHA2DS2-VASc 评分每增加 1 分,颈动脉斑块的患病率增加 37%。ROC 曲线分析显示,男性患者 CHA2DS2-VASc 评分≥2(敏感性,44.67%;特异性,75.64%;AUC,0.639)或女性患者 CHA2DS2-VASc 评分≥3(敏感性,47.24%;特异性,72.40%;AUC,0.634)与颈动脉斑块相关。

结论

NVAF 患者颈动脉斑块的患病率与 CHA2DS2-VASc 评分相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0568/6368281/9727eb3eda14/pone.0210945.g001.jpg

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