Enhancing the evaluation of acute ischemic stroke risk in individuals with non-valvular atrial fibrillation by...

Area of Science:

• Cardiology
• Neurology
• Clinical Medicine

Background:

• Non-valvular atrial fibrillation (NVAF) is a significant risk factor for ischemic stroke.
• Predictive scores like CHA₂DS₂-VASc are used, but novel biomarkers may enhance risk stratification.
• Lipoprotein (a) [Lp(a)] and red blood cell distribution width (RDW) are implicated in cardiovascular and cerebrovascular diseases.

Purpose of the Study:

• To evaluate the clinical significance of the CHA₂DS₂-VASc-60 score, Lp(a), and RDW in NVAF patients experiencing acute ischemic stroke (AIS).
• To assess the combined predictive value of these markers for AIS in NVAF patients.

Main Methods:

• Retrospective analysis of 313 NVAF patients (150 with AIS, 163 without) hospitalized between April 2020 and April 2023.
• Calculation of CHA₂DS₂-VASc-60 scores and measurement of Lp(a) and RDW levels.
• Statistical analysis including correlation, multivariate logistic regression, and ROC curve analysis.

Main Results:

• CHA₂DS₂-VASc-60 score, Lp(a), and RDW were significantly higher in NVAF patients with AIS compared to those without.
• CHA₂DS₂-VASc-60 score, Lp(a), and RDW were identified as independent risk factors for AIS in NVAF patients.
• The combination of CHA₂DS₂-VASc-60 score, Lp(a), and RDW demonstrated a high predictive capacity for AIS in NVAF patients (AUC=0.906).

Conclusions:

• Elevated CHA₂DS₂-VASc-60 score, Lp(a), and RDW are significant independent risk factors for AIS in NVAF patients.
• The combined assessment of these markers offers enhanced predictive value for identifying NVAF patients at high risk of AIS.