ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1561446
This article is part of the Research TopicAssociation of Cardiovascular Diseases with Neuropsychiatric SymptomsView all 3 articles
Construction and validation of a nomogram for predicting 3-month outcome in elderly patients with nonvalvular atrial fibrillation-induced acute ischemic stroke
Provisionally accepted
Yang Yang
Xiaohong Zhang*- Third Affiliated Hospital of Anhui Medical University, Hefei, China
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Aim: Cardiogenic embolism caused by atrial fibrillation (AF) leads to higher disability, mortality, and recurrence rates compared to stroke independent of AF, resulting in a poorer prognosis for patients. Effective risk assessment and timely clinical intervention are essential. This study aimed to develop and validate a personalized nomogram to predict the 3-month outcomes for elderly patients with nonvalvular atrial fibrillation (NVAF) induced acute ischemic stroke (AIS). 1.071-1.284), glycated hemoglobin (HbA1c) (OR= 2.211; 95% CI:1.573-3.220), Ddimer (OR=1.157; 95% CI: 1.022-1.361), neutrophil-to-lymphocyte ratio (NLR) (OR = 1.531; 95%CI:1.242-1.972), and left atrial diameter (LAD) (OR=1.163; 95%CI: 1.072-1.280). A nomogram was created based on these factors. The area under the ROC curve(AUC) for the nomogram was 0.933 (95%CI:0.897-0.969) before and 0.933(95%CI:0.895-0.964) after internal validation, demonstrating good discriminative ability. The nomogram also showed excellent calibration and clinical applicability, as confirmed by calibration curve analysis and DCA. Conclusion: Stroke history, NIHSS score, HbA1c, D-dimer, NLR, and LAD are independent risk factors for poor outcomes in elderly patients with NVAF-AIS. The nomogram, integrating these factors, provides intuitive, individualized predictions for the risk of poor outcomes, aiding in the selection of treatment options for these patients.
Keywords: Acute ischemic stroke, Nonvalvular atrial fibrillation, prognosis, nomogram, Clinical risk prediction model
Received: 15 Jan 2025; Accepted: 25 Apr 2025.
Copyright: © 2025 Yang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaohong Zhang, Third Affiliated Hospital of Anhui Medical University, Hefei, China
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