Objective: To assess the utility of combined neutrophil-to-lymphocyte ratio (NLR) and D-dimer detection in determining the severity and short-term prognosis of acute cardiogenic cerebral embolism in older adults.
Methods: A total of 202 elderly patients with NVAF who were hospitalized in the Third Affiliated Hospital of Anhui Medical University from April 1, 2020, to April 1, 2023, were selected and divided into the observation group (69 patients with NVAF combined with ACCE) and the control group (133 patients with NVAF alone) according to whether they had acute cardiogenic cerebral embolism. According to the National Institutes of Health Stroke Scale (NIHSS), the observation group was divided into mild, moderate, and severe cerebral infarction groups: 26 cases (MICI group), 29 cases (MOCI group) and 14 cases (SCI group), respectively. According to the modified Rankin scale (mRS) after 3 months, 30 cases were divided into the good prognosis group and 39 cases were divided into the poor prognosis group. The D-dimer and NLR levels were detected in the two groups. Logistic regression was used to analyze whether the two factors were factors affecting the short-term prognosis of patients with acute cardiogenic cerebral embolism, and the ROC curve was drawn to evaluate the value of the two combined tests on the short-term prognosis of patients with acute cardiogenic cerebral embolism RESULTS: The levels of D-dimer and NLR in peripheral blood in SCI group [1.82 (0.68-6.71) mg/l, 4.55 (2.31-6.68)] were higher than those in MOCI group [1.16 (0.65-1.90) mg/l, 3.84 (3.14-6.87)] and MICI group [0.53(0.32-0.90) mg/l, 2.46(2.09-3.79)]; The difference between groups was statistically significant (P<0.05). Logistic regression analysis showed that D-dimer and NLR were independent risk factors for poor prognosis in patients with acute cardiogenic cerebral embolism (OR values were 1.772 and 1.603, and 95%CI were 1.060-2.963 and 1.100-2.338, respectively, both P<0.05). The AUC of D-dimer combined with NLR for predicting poor prognosis of acute cardiogenic cerebral embolism was 0.812, which is better than D-dimer and NLR alone.
Conclusion: Peripheral blood D-dimer combined with NLR detection is helpful for the risk stratification and short-term prognosis assessment of patients with acute cardiogenic cerebral embolism. Clinical detection is of great significance for the prevention and monitoring of disease development.
Keywords: Acute cardiogenic cerebral embolism; D-dimer; Nerve function defect; Neutrophil-to-lymphocyte ratio; Non-valvular atrial fibrillation; Prognosis.
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