Relationship between left atrial diameter and ischemic stroke in the elderly patients with non-valvular atrial fibrillation

  Objective  To investigate the relationship between left atrial diameter (LAD) and ischemic stroke in the elderly patients with non-valvular atrial fibrillation.

  Methods  According to the history of ischemic stroke, 325 patients with non-valvular atrial fibrillation were divided into atrial fibrillation with stroke group (n=127) and atrial fibrillation without stroke group (n=198). Blood glucose, creatinine clearance rate, blood lipid, comorbidities, LAD and other clinical data were compared between the two groups.Logistic regressions were used to analyze the correlation between LAD and the risk of ischemic stroke.Receiver Operating Characteristic (ROC) curve was drew and used to evaluate the predictive value of LAD in ischemic stroke.

  Results  The average age, the proportion of female patients, the proportion of patients complicating with heart failure and hypertension, the CHA₂DS₂-VASc score, LAD, creatinine (Cr) and uric acid (UA) levels in the atrial fibrillation with stroke group were significantly higher than those in the atrial fibrillation without stroke group, the proportion of patients with paroxysmal atrial fibrillation and the level of estimated glomerular filtration rate (eGFR) were significantly lower than those in patients with atrial fibrillation without stroke group (P < 0.05 or P < 0.01). Multivariate Logistic regression analysis showed LAD was positively correlated with ischemic stroke(P < 0.01). ROC curve showed LAD could predict the risk of ischemic stroke (P < 0.01).The area under the curve (AUC) of LAD combined with CHA2DS2-VASC score was 0.904.

  Conclusion  LAD is positively correlated with the risk of ischemic stroke in patients with non-valvular atrial fibrillation, and LAD combined with CHA₂DS₂-VASc score can better predict the risk of ischemic stroke in patients with non-valvular atrial fibrillation.