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Silent brain infarcts impact on cognitive function in atrial fibrillation.
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift) |
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ID |
4658555 |
Author(s) |
Kühne, Michael; Krisai, Philipp; Coslovsky, Michael; Rodondi, Nicolas; Müller, Andreas; Beer, Jürg H; Ammann, Peter; Auricchio, Angelo; Moschovitis, Giorgio; Hayoz, Daniel; Kobza, Richard; Shah, Dipen; Stephan, Frank Peter; Schläpfer, Jürg; Di Valentino, Marcello; Aeschbacher, Stefanie; Ehret, Georg; Eken, Ceylan; Monsch, Andreas; Roten, Laurent; Schwenkglenks, Matthias; Springer, Anne; Sticherling, Christian; Reichlin, Tobias; Zuern, Christine S; Meyre, Pascal B; Blum, Steffen; Sinnecker, Tim; Würfel, Jens; Bonati, Leo H; Conen, David; Osswald, Stefan; Swiss-AF Investigators, |
Author(s) at UniBasel |
Schwenkglenks, Matthias
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Year |
2022 |
Title |
Silent brain infarcts impact on cognitive function in atrial fibrillation. |
Journal |
European heart journal |
Volume |
43 |
Number |
22 |
Pages / Article-Number |
2127-2135 |
Keywords |
Atrial fibrillation; Brain infarction; Cognitive function; Magnetic resonance imaging; Oral anticoagulation |
Mesh terms |
Aged; Atrial Fibrillation, complications, pathology; Brain, diagnostic imaging, pathology; Brain Infarction; Cognition; Cohort Studies; Female; Humans; Ischemic Attack, Transient, complications; Magnetic Resonance Imaging; Male; Prospective Studies; Stroke, pathology |
Abstract |
We aimed to investigate the association of clinically overt and silent brain lesions with cognitive function in atrial fibrillation (AF) patients.; We enrolled 1227 AF patients in a prospective, multicentre cohort study (Swiss-AF). Patients underwent standardized brain magnetic resonance imaging (MRI) at baseline and after 2 years. We quantified new small non-cortical infarcts (SNCIs) and large non-cortical or cortical infarcts (LNCCIs), white matter lesions (WML), and microbleeds (Mb). Clinically, silent infarcts were defined as new SNCI/LNCCI on follow-up MRI in patients without a clinical stroke or transient ischaemic attack (TIA) during follow-up. Cognition was assessed using validated tests. The mean age was 71 years, 26.1% were females, and 89.9% were anticoagulated. Twenty-eight patients (2.3%) experienced a stroke/TIA during 2 years of follow-up. Of the 68 (5.5%) patients with ≥1 SNCI/LNCCI, 60 (88.2%) were anticoagulated at baseline and 58 (85.3%) had a silent infarct. Patients with brain infarcts had a larger decline in cognition [median (interquartile range)] changes in Cognitive Construct score [-0.12 (-0.22; -0.07)] than patients without new brain infarcts [0.07 (-0.09; 0.25)]. New WML or Mb were not associated with cognitive decline.; In a contemporary cohort of AF patients, 5.5% had a new brain infarct on MRI after 2 years. The majority of these infarcts was clinically silent and occurred in anticoagulated patients. Clinically, overt and silent brain infarcts had a similar impact on cognitive decline.; ClinicalTrials.gov Identifier: NCT02105844, https://clinicaltrials.gov/ct2/show/NCT02105844. |
ISSN/ISBN |
1522-9645 |
Full Text on edoc |
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Digital Object Identifier DOI |
10.1093/eurheartj/ehac020 |
PubMed ID |
http://www.ncbi.nlm.nih.gov/pubmed/35171989 |
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28/04/2024
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