scholarly journals Frailty and cognitive impairment are not reasons to withhold anticoagulation in people with atrial fibrillation but screening could guide management

2021 ◽  
Author(s):  
Stephanie L. Harrison ◽  
Asangaedem Akpan ◽  
Gregory Y. H. Lip
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Impairment

Atrial fibrillation and prestroke cognitive impairment in stroke

2014 ◽  
Vol 261 (3) ◽  
pp. 546-553 ◽  
Author(s):  
Solveig Horstmann ◽  
Timolaos Rizos ◽  
Geraldine Rauch ◽  
Maximilian Fuchs ◽  
Cathrin Arden ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Impairment

Abstract 44: Associations of Atrial Fibrillation, Neuroimaging Measures of Cerebrovascular Disease and Alzheimer’S Disease-related Pathology, and Cognitive Impairment

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Jonathan Graff-Radford ◽  
Rosebud Roberts ◽  
Malini Madhavan ◽  
Alejandro Rabinstein ◽  
Ruth Cha ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
White Matter ◽  
Cerebrovascular Disease ◽  
Regression Models ◽  
Grey Matter ◽  
White Matter Hyperintensity ◽  
Carrier Status

The objective of this study was to investigate the cross-sectional associations of atrial fibrillation with neuroimaging measures of cerebrovascular disease and Alzheimer’s disease-related pathology, and their interaction with cognitive impairment. MRI scans of non-demented individuals (n=1044) from the population-based Mayo Clinic Study of Aging were analyzed for infarctions, total grey matter, hippocampal and white matter hyperintensity volumes. A subset of 496 individuals underwent FDG and C-11 Pittsburgh compound B (PiB) PET scans. We assessed the associations of atrial fibrillation with i) categorical MRI measures (cortical and subcortical infarctions) using multivariable logistic regression models, and with ii) continuous MRI measures ( hippocampal, total grey matter, and white matter hyperintensity volumes) and FDG-PET and PiB-PET measures using multivariable linear regression models, and adjusting for confounders. Among participants who underwent MRI (median age, 77.8, 51.6% male), 13.5% had atrial fibrillation. Presence of atrial fibrillation was associated with subcortical infarctions (odds ratio [OR], 1.83; p=0.002), cortical infarctions (OR, 1.91; p=0.03), total grey matter volume (Beta [β], -.025, p<.0001) after controlling for age, education, gender, APOE e4 carrier status, coronary artery disease, diabetes, history of clinical stroke, and hypertension. However, atrial fibrillation was not associated with white matter hyperintensity volume, hippocampal volume, Alzheimer’s pattern of FDG hypometabolism or PiB uptake. There was a significant interaction of cortical infarction (p for interaction=0.004) and subcortical infarction (p for interaction =0.015) with atrial fibrillation with regards to odds of mild cognitive impairment (MCI). Using subjects with no atrial fibrillation and no infarction as the reference, the OR (95% confidence intervals [CI]) for MCI was 2.98 (1.66, 5.35;p = 0.0002) among participants with atrial fibrillation and any infarction, 0.69 (0.36, 1.33;p= 0.27) for atrial fibrillation and no infarction, and 1.50 (0.96, 2.32;p = 0.07) for no atrial fibrillation and any infarction. These data highlight that atrial fibrillation is associated with MCI in the presence of infarctions.

scholarly journals Risk of cognitive impairment with non-vitamin K antagonist oral anticoagulants in atrial fibrillation

Medicine ◽  
2018 ◽  
Vol 97 (34) ◽  
pp. e12072 ◽  
Author(s):  
Long Shen ◽  
Chi Zhang ◽  
Zhi-Chun Gu ◽  
Hou-Wen Lin ◽  
Xiao-Yan Liu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist

scholarly journals Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study

2021 ◽  
Author(s):  
Arjola Bano ◽  
Nicolas Rodondi ◽  
Jürg H. Beer ◽  
Giorgio Moschovitis ◽  
Richard Kobza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Unique Identifier ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
History Of

Background Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF. Methods and Results Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities. Conclusions Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02105844.

scholarly journals Cognitive Impairment Associated With Atrial Fibrillation

2013 ◽  
Vol 158 (5_Part_1) ◽  
pp. 338 ◽  
Author(s):  
Shadi Kalantarian ◽  
Theodore A. Stern ◽  
Moussa Mansour ◽  
Jeremy N. Ruskin
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Impairment

scholarly journals Association Between Atrial Fibrillation and Cognitive Impairment in Individuals With Prior Stroke

Stroke ◽  
2020 ◽  
Vol 51 (6) ◽  
pp. 1662-1666 ◽  
Author(s):  
Damianos G. Kokkinidis ◽  
Nikos Zareifopoulos ◽  
Christina A. Theochari ◽  
Angelos Arfaras-Melainis ◽  
Christos A. Papanastasiou ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Adjusted Analysis ◽  
End Point ◽  
History Of ◽  
The Impact ◽  
Prior Stroke ◽  
Unadjusted Analysis

Background and Purpose— Atrial fibrillation (AF) is the most common chronic arrhythmia. Dementia and cognitive impairment (CI) are major burdens to public health. The prevalence of all 3 entities is projected to increase due to population aging. Previous reports have linked AF with a higher risk of CI and dementia in patients without prior stroke. Stroke is known to increase the risk for dementia and CI. It is unclear if AF in patients with history of stroke can further increase the risk for dementia or CI. Our purpose was to evaluate the impact of AF on risk for dementia or CI among patients with history of stroke. Methods— Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. Pubmed, Scopus, and Cochrane central were searched. The outcomes of interest were dementia, CI, and the composite end point of dementia or CI. A random-effect model meta-analysis was performed. Meta-regression analysis was also performed. Publication bias was assessed with the Egger test and with funnel plots. Results— Fourteen studies and 14 360 patients (1363 with AF) were included in the meta-analysis. In the meta-analysis of adjusted odds ratio, AF was associated with increased risk of CI (odds ratio, 1.60 [95% CI, 1.20–2.14]), dementia (odds ratio, 3.11 [95% CI, 2.05–4.73]), and the composite end point of CI or dementia (odds ratio, 2.26 [95% CI, 1.61–3.19]). The heterogeneity for the composite end point of dementia or CI was moderate (adjusted analysis). The heterogeneity for the analysis of the end point of CI only was substantial in the unadjusted analysis and moderate in the adjusted analysis. The heterogeneity for the end point of dementia only was moderate in the unadjusted analysis and zero in the adjusted analysis. Conclusions— Our results indicate that an association between AF and CI or dementia is patients with prior strokes is possible given the persistent positive associations we noticed in the unadjusted and adjusted analyses. The heterogeneity levels limit the certainty of our findings.

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