Key result
Higher Platelet-To-Lymphocyte Ratio and left atrial diameter were independently associated with silent brain infarction (LAD OR 1.092, 95% CI 1.054-1.130; PLR OR 1.004, 95% CI 1.001-1.007).
Why the study?
Silent brain infarction incidence remains high even in low-risk atrial fibrillation patients, but risk factors for silent brain infarction in this group are not fully established.
What are the independent risk factors for silent brain infarction in low-risk nonvalvular atrial fibrillation patients?
Observational (n=301)
What are the independent risk factors for silent brain infarction in low-risk nonvalvular atrial fibrillation patients?
Odds Ratio: 1.092 (95% CI 1.054–1.13)
p-value: p=<0.001
Platelet-to-lymphocyte ratio and left atrial diameter are independent predictors of silent brain infarction in low-risk patients with nonvalvular atrial fibrillation.
Background: Silent Brain Infarction (SBI) has been found to be linked to an increased risk of cognitive impairment and future symptomatic stroke. Atrial fibrillation is a significant risk factor for SBI. Even in low-risk atrial fibrillation patients, the incidence of SBI remains high. This study aims to investigate the risk factors for SBI in nonvalvular atrial fibrillation (NVAF) patients with a CHA2DS2-VASc score of 0 to 1. Methods: A total of 301 consecutive low-risk NVAF patients (male: CHA2DS2-VASc=0, female: CHA2DS2-VASc=1) were enrolled. According to brain Magnetic Resonance Imaging (MRI), patients were divided into SBI (n=90) and non-SBI (n=211) groups. Baseline characteristics, blood parameters, and echocardiography results were analyzed. Multivariate logistic regression was performed to identify independent predictors. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the diagnostic power of the relevant risk factors. Results: The study revealed that neutrophil count, monocyte count, Platelet-To-Lymphocyte Ratio (PLR), neutrophil-to-high density lipoprotein cholesterol ratio (NHR), and left atrial diameter (LAD) were significantly higher in the SBI group than non-SBI group (p <0.05). Multivariate logistic regression analysis identified PLR (OR, 1.004; 95%CI 1.001-1.007; p =0.026) and LAD (OR 1.092; 95%CI 1.054-1.130; p <0.001) as the independent risk factors associated with SBI. The ROC showed that the Area Under the Curve (AUC) of PLR is 0.589 (95%CI 0.515- 0.662; p =0.015) with an optimal cut-off point of 151 (sensitivity 43.3%, specificity 74.6%). The AUC of LAD is 0.676 (95%CI 0.606-0.746; p <0.001) with an optimal cut-off point of 39 mm (sensitivity 61.1%, specificity 72.0%). The AUC of PLR combined with LAD is 0.711 (95%CI 0.646-0.777; p <0.001) with a sensitivity of 63.3% and specificity of 73.5% for SBI. Conclusion: PLR and LAD can be independent risk factors for SBI in NVAF patients with low CHA2DS2-VASc scores. The combination of the two factors can enhance the predictive ability of SBI in these patients.
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Hao et al. (2024) conducted an observational in Nonvalvular atrial fibrillation (NVAF) with low CHA2DS2-VASc score (n=301). Platelet-To-Lymphocyte Ratio (PLR) and left atrial diameter (LAD) was evaluated on Silent Brain Infarction (SBI) (OR 1.092, 95% CI 1.054-1.130, p=<0.001). Higher Platelet-To-Lymphocyte Ratio and left atrial diameter were independently associated with silent brain infarction (LAD OR 1.092, 95% CI 1.054-1.130; PLR OR 1.004, 95% CI 1.001-1.007).
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