Author(s) |
Koh, Yu Han
Lew, Leslie Z W
Franke, Kyle B
Elliott, Adrian D
Lau, Dennis H
Thiyagarajah, Anand
Linz, Dominik
Arstall, Margaret
Tully, Phillip J
Baune, Bernhard T
Munawar, Dian A
Mahajan, Rajiv
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Publication Date |
2022-08
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Abstract |
<p><b>Aims</b><br/>
To systematic review and meta-analyse the association and mechanistic links between atrial fibrillation (AF) and cognitive impairment.</p>
<p><b>Methods and results</b><br/>
PubMed, EMBASE, and Cochrane Library were searched up to 27 March 2021 and yielded 4534 citations. After exclusions, 61 were analysed; 15 and 6 studies reported on the association of AF and cognitive impairment in the general population and post-stroke cohorts, respectively. Thirty-six studies reported on the neuro-pathological changes in patients with AF; of those, 13 reported on silent cerebral infarction (SCI) and 11 reported on cerebral microbleeds (CMB). Atrial fibrillation was associated with 39% increased risk of cognitive impairment in the general population [<i>n</i> = 15: 2 822 974 patients; hazard ratio = 1.39; 95% confidence interval (CI) 1.25–1.53, <i>I</i><sup>2</sup> = 90.3%; follow-up 3.8–25 years]. In the post-stroke cohort, AF was associated with a 2.70-fold increased risk of cognitive impairment [adjusted odds ratio (OR) 2.70; 95% CI 1.66–3.74, <i>I</i><sup>2</sup> = 0.0%; follow-up 0.25–3.78 years]. Atrial fibrillation was associated with cerebral small vessel disease, such as white matter hyperintensities and CMB (<i>n</i> = 8: 3698 patients; OR = 1.38; 95% CI 1.11–1.73, <i>I</i><sup>2</sup> = 0.0%), SCI (<i>n</i> = 13: 6188 patients; OR = 2.11; 95% CI 1.58–2.64, <i>I</i><sup>2</sup> = 0%), and decreased cerebral perfusion and cerebral volume even in the absence of clinical stroke.</p>
<p><b>Conclusion</b><br/>
Atrial fibrillation is associated with increased risk of cognitive impairment. The association with cerebral small vessel disease and cerebral atrophy secondary to cardioembolism and cerebral hypoperfusion may suggest a plausible link in the absence of clinical stroke.</p>
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Citation |
Europace, 24(8), p. 1229-1239
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ISSN |
1532-2092
1099-5129
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Pubmed ID |
35061884
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Link | |
Publisher |
Oxford University Press
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Rights |
Attribution 4.0 International
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Title |
Predictive role of atrial fibrillation in cognitive decline: a systematic review and meta-analysis of 2.8 million individuals
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Type of document |
Journal Article
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Entity Type |
Publication
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