Combined predictive value of uric acid and serum lipid for stroke events in non-valvular atrial fibrillation patients

Figures

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  Figure 1. Flowchart of the included patients and follow-up. AF, atrial fibrillation; Scr, serum creatinine; CKD, chronic kidney diseases.

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  Figure 2. Serum uric acid (A), TG (B) and age (C) in patients with or without stroke. The correlation of SUA and TG in total population (D), males (E) and females (F).

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  Figure 3. Multivariable adjusted hazard ratios for stroke incidence according to levels of SUA and TG on a continuous scale. Red lines are multivariable-adjusted hazard ratios, with pink areas showing 95% CIs derived from restricted cubic spline regressions with three knots at the 25th, 50th, and 75th percentiles. The dashed grey lines indicate reference lines for no association at a hazard ratio of 1.0. Analyses were adjusted for age, previous TIA stroke, SUA, and TG.

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  Figure 4. Kaplan–Meier curves showing the incidence of stroke for different levels of SUA and TG. (A) A Kaplan–Meier survival curves for TG, the cut-off points for TG 1.28 mmol/L in males and 1.29 mmol/L in females, respectively. (B) Kaplan–Meier survival curves for SUA; the cut points for SUA were 400 µmol/L in males and 330 µmol/L in females, respectively.

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  Figure 5. Kaplan–Meier curve showing the incidence of stroke. All patients were divided into 4 categories. Group 1: patients with both low-level SUA and TG (blue); Group 2: patients with high-level SUA and low-level TG (red); Group 3: patients with high-level TG and low-level SUA (green); Group 4: patients with high levels of both TG and SUA (orange).

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  Figure 6. Model-comparison results of predicting the 31-month incidence of IS. (A) Receiver operating characteristics (ROC) curves of freedom from stroke at 31 months for the different models. (B) Calibration curves for the final model (CHA2DS2-VASc+SUA+TG+LDL). The dotted line represents the entire cohort and the solid line is the result after bias correction by bootstrapping (1,000 repetitions), indicating model performance (boot mean absolute error = 0.007).

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  Figure 7. Decision curve analyses (DCA) of the CHA2DS2-VASc model and final model for 31 months of stroke incidence. The x-axis indicates the threshold incidence for stroke at 31 months, and the y-axis indicates the net benefit. The horizontal dark grey line assumes no patients will experience the event; the light grey line assumes all patients will experience the event. The final model had enhanced net benefit compared with the CHA2DS2-VASc model at risk threshold >2.6%.

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  Figure 8. SUA, TG, and LDL promote and maintain AF through inflammation while acting directly on intracranial vessels, leading to IS.