The association of CHA2DS2-VASc score and carotid plaque in patients with non-valvular atrial fibrillation
The association of CHA2DS2-VASc score and carotid plaque in patients with non-valvular atrial fibrillation
复制标题
非瓣膜性房颤患者CHA(2)DS(2)-VASc评分与颈动脉斑块的相关性
DOI：
10.1371/journal.pone.0210945
复制
发表时间：
2019-02-08
期刊：
影响因子：
3.7
通讯作者：
Tang, Baopeng
中科院分区：
文献类型：
--
作者：
Shang, Luxiang;Zhao, Yang;Tang, Baopeng
目的：本研究旨在评估非瓣膜性心房颤动（NVAF）患者的CHA₂DS₂ - VASc评分与颈动脉斑块之间的关联。
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临床资料。采用卡方趋势检验分析随着CHA₂DS₂ - VASc评分增加颈动脉斑块患病率的趋势。还使用单变量和多变量逻辑回归评估颈动脉斑块与CHA₂DS₂ - VASc评分之间的关联。通过受试者工作特征（ROC）曲线下面积（AUC）确定NVAF患者不同CHA₂DS₂ - VASc评分的最佳截断值。
结果：与无颈动脉斑块的患者相比，有颈动脉斑块的NVAF患者CHA₂DS₂ - VASc评分更高（3.01 ± 1.36对2.55 ± 1.28，P < 0.05）。在所有参与者、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）。多变量逻辑回归分析表明，CHA₂DS₂ - VASc评分每增加1分，颈动脉斑块的患病率相应增加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≥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。
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.