The association between cerebral microbleeds and CHA 2DS 2-VASc score in patients with atrial fibrillation / 中华老年医学杂志

ABSTRACT

Objective:To investigate the association between the cerebral microbleeds(CMBs)and CHA 2DS 2-VASc score in patients with non-valvular atrial fibrillation(NVAF), and to analyze the related risk factors for CMBs. Method:This was a retrospective case-control study.A total of 164 patients with NVAF who had performed brain magnetic resonance susceptibility weighted imaging in Zhejiang Hospital from January 2015 to December 2017 were included.Based on the presence of CMBs, all patients were divided into the CMBs group(n=43, 26.2%)and the non-CMBs group(n=121, 73.8%). We collected the data about clinical characteristics, CHA2DS2-VASc score and number of CMBs.The association between CMBs and CHA2DS2-VASc score was analyzed by Spearman linear test.The Logistic regression analyses was used to evaluate the association between CMBs and the risk factors, including age, hypertension, etc.Results:The incidence of CMBs was markedly increased with the increase of CHA 2DS 2-VASc score( P<0.05). Besides, the rate of CMBs ≥5 was also positively associated with CHA 2DS 2-VASc score( P<0.05). Patients in the CMBs group was significantly older than those in the non-CMBs group[(81.0±8.1)years vs.(75.4±11.2)years, P<0.01]. There were significantly differences in rates of hypertension(83.7% vs. 63.2%), moderate-severe leukoaraiosis(44.2% vs.33.9%), anticoagulant therapy(34.9% vs.19.0%)and median CHA 2DS 2-VASc score(4 vs.3)between the CMBs group and the non-CMBs group(all P<0.05). Logistic regression analyses showed that age and anticoagulant therapy were the independent risk factors of CMBs in NVAF patients(all P<0.05). Conclusion:CMBs is strongly associated with CHA 2DS 2-VASc score in patients with NVAF.Age and anticoagulant therapy are its independent risk factors.It is necessary to detect the possibility of CMBs in old NVAF patients with high CHA 2DS 2-VASc score before and during anticoagulant therapy.