Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation
BackgroundNon-valvular atrial fibrillation (NVAF) is the most common cause of cardiogenic cerebral embolism (CCE). However, the underlying mechanism between cerebral embolism and NVAF is indefinite, and there is no effective and convenient biomarker to identify potential risk of CCE in patients with...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1069261/full |
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| author | Yachen Shi Yachen Shi Yachen Shi Chenhao Xuan Wei Ji Wei Ji Feng Wang Feng Wang Jin Huang Jin Huang Lei Li Lei Li Hui Wang Hui Wang Jingyu Deng Jingyu Deng Junfei Shao Kefei Chen Kefei Chen Xuqiang Mao Qinghua Xu Yiping You Yiping You Guangjun Xi Guangjun Xi |
| author_facet | Yachen Shi Yachen Shi Yachen Shi Chenhao Xuan Wei Ji Wei Ji Feng Wang Feng Wang Jin Huang Jin Huang Lei Li Lei Li Hui Wang Hui Wang Jingyu Deng Jingyu Deng Junfei Shao Kefei Chen Kefei Chen Xuqiang Mao Qinghua Xu Yiping You Yiping You Guangjun Xi Guangjun Xi |
| author_sort | Yachen Shi |
| collection | DOAJ |
| description | BackgroundNon-valvular atrial fibrillation (NVAF) is the most common cause of cardiogenic cerebral embolism (CCE). However, the underlying mechanism between cerebral embolism and NVAF is indefinite, and there is no effective and convenient biomarker to identify potential risk of CCE in patients with NVAF in clinic. The present study aims to identify risk factors for interpreting the potential association of CCE with NVAF and providing valuable biomarkers to predict the risk of CCE for NVAF patients.Methods641 NVAF patients diagnosed with CCE and 284 NVAF patients without any history of stroke were recruited in the present study. Clinical data including demographic characteristics, medical history, and clinical assessments, were recorded. Meanwhile, Blood cell counts, lipid profiles, high-sensitivity C-reactive protein, and coagulation function-related indicators were measured. Least absolute shrinkage and selection operator (LASSO) regression analysis was utilized to build a composite indicator model based on the blood risk factors.Results(1) CCE patients had significantly increased neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and D-dimer levels as compared with patients in the NVAF group, and these three indicators can distinguish CCE patients from ones in the NVAF group with an area under the curve (AUC) value of over 0.750, respectively. (2) Using the LASSO model, a composite indicator, i.e., the risk score, was determined based on PLR and D-dimer and displayed differential power for distinguishing CCE patients from NVAF patients with an AUC value of over 0.934. (3) The risk score was positively correlated with the National Institutes of Health Stroke Scale and CHADS2 scores in CCE patients. (4) There was a significant association between the change value of the risk score and the recurrence time of stroke in initial CCE patients.ConclusionsThe PLR and D-dimer represent an aggravated process of inflammation and thrombosis in the occurrence of CCE after NVAF. The combination of these two risk factors can contribute to identifying the risk of CCE for patients with NVAF with an accuracy of 93.4%, and the greater in change of composite indicator, the shorter in the recurrence of CCE for NVAF patients. |
| first_indexed | 2024-04-10T16:41:48Z |
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| language | English |
| last_indexed | 2024-04-10T16:41:48Z |
| publishDate | 2023-02-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-107fb9cbb2e34c3c872d36049854252b2023-02-08T06:14:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-02-011410.3389/fneur.2023.10692611069261Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillationYachen Shi0Yachen Shi1Yachen Shi2Chenhao Xuan3Wei Ji4Wei Ji5Feng Wang6Feng Wang7Jin Huang8Jin Huang9Lei Li10Lei Li11Hui Wang12Hui Wang13Jingyu Deng14Jingyu Deng15Junfei Shao16Kefei Chen17Kefei Chen18Xuqiang Mao19Qinghua Xu20Yiping You21Yiping You22Guangjun Xi23Guangjun Xi24Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, ChinaBackgroundNon-valvular atrial fibrillation (NVAF) is the most common cause of cardiogenic cerebral embolism (CCE). However, the underlying mechanism between cerebral embolism and NVAF is indefinite, and there is no effective and convenient biomarker to identify potential risk of CCE in patients with NVAF in clinic. The present study aims to identify risk factors for interpreting the potential association of CCE with NVAF and providing valuable biomarkers to predict the risk of CCE for NVAF patients.Methods641 NVAF patients diagnosed with CCE and 284 NVAF patients without any history of stroke were recruited in the present study. Clinical data including demographic characteristics, medical history, and clinical assessments, were recorded. Meanwhile, Blood cell counts, lipid profiles, high-sensitivity C-reactive protein, and coagulation function-related indicators were measured. Least absolute shrinkage and selection operator (LASSO) regression analysis was utilized to build a composite indicator model based on the blood risk factors.Results(1) CCE patients had significantly increased neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and D-dimer levels as compared with patients in the NVAF group, and these three indicators can distinguish CCE patients from ones in the NVAF group with an area under the curve (AUC) value of over 0.750, respectively. (2) Using the LASSO model, a composite indicator, i.e., the risk score, was determined based on PLR and D-dimer and displayed differential power for distinguishing CCE patients from NVAF patients with an AUC value of over 0.934. (3) The risk score was positively correlated with the National Institutes of Health Stroke Scale and CHADS2 scores in CCE patients. (4) There was a significant association between the change value of the risk score and the recurrence time of stroke in initial CCE patients.ConclusionsThe PLR and D-dimer represent an aggravated process of inflammation and thrombosis in the occurrence of CCE after NVAF. The combination of these two risk factors can contribute to identifying the risk of CCE for patients with NVAF with an accuracy of 93.4%, and the greater in change of composite indicator, the shorter in the recurrence of CCE for NVAF patients.https://www.frontiersin.org/articles/10.3389/fneur.2023.1069261/fullnon-valvular atrial fibrillationcardiogenic cerebral embolismplatelet-to-lymphocyte ratioD-dimerleast absolute shrinkage and selection operator |
| spellingShingle | Yachen Shi Yachen Shi Yachen Shi Chenhao Xuan Wei Ji Wei Ji Feng Wang Feng Wang Jin Huang Jin Huang Lei Li Lei Li Hui Wang Hui Wang Jingyu Deng Jingyu Deng Junfei Shao Kefei Chen Kefei Chen Xuqiang Mao Qinghua Xu Yiping You Yiping You Guangjun Xi Guangjun Xi Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation Frontiers in Neurology non-valvular atrial fibrillation cardiogenic cerebral embolism platelet-to-lymphocyte ratio D-dimer least absolute shrinkage and selection operator |
| title | Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation |
| title_full | Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation |
| title_fullStr | Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation |
| title_full_unstemmed | Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation |
| title_short | Combination of platelet-to-lymphocyte ratio and D-dimer for the identification of cardiogenic cerebral embolism in non-valvular atrial fibrillation |
| title_sort | combination of platelet to lymphocyte ratio and d dimer for the identification of cardiogenic cerebral embolism in non valvular atrial fibrillation |
| topic | non-valvular atrial fibrillation cardiogenic cerebral embolism platelet-to-lymphocyte ratio D-dimer least absolute shrinkage and selection operator |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1069261/full |
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