无中风的房颤患者患痴呆症的风险：来自社区队列的数据。
Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a community-based cohort.
作者信息
Miyasaka Yoko, Barnes Marion E, Petersen Ronald C, Cha Stephen S, Bailey Kent R, Gersh Bernard J, Casaclang-Verzosa Grace, Abhayaratna Walter P, Seward James B, Iwasaka Toshiji, Tsang Teresa S M
机构信息
Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic, 200 First Street, SW., Rochester, MN 55905, USA.
出版信息
Eur Heart J. 2007 Aug;28(16):1962-7. doi: 10.1093/eurheartj/ehm012. Epub 2007 Apr 25.
AIMS
To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort.
METHODS AND RESULTS
Olmsted County, Minnesota adult residents diagnosed with first AF during 1986-2000 were identified, and followed until 2004. The primary outcome was new detection of dementia. Interim stroke was censored in the analyses. Of 2837 subjects (71 +/- 15 years old) diagnosed with first AF and without any evidence of cognitive dysfunction or stroke at the time of AF onset, 299 were diagnosed with dementia during a median follow-up of 4.6 years [interquartile (IQR) range 1.5-7.9 years], and 1638 died. The Kaplan-Meier cumulative rate of dementia was 2.7% at 1 year and 10.5% at 5 years. After adjustment for age and sex, dementia was strongly related to advancing age [hazard ratio (HR)/10 years, 2.8; 95% confidence interval (CI), 2.5-3.2], but did not vary with sex (P = 0.52). The occurrence of post-AF dementia was associated with significantly increased mortality risk (HR 2.9; 95% CI 2.5-3.3), even after adjustment for multiple comorbidities, and did not vary with age (P = 0.75) or sex (P = 0.33).
CONCLUSION
Dementia appeared common following the diagnosis of first AF, and was associated with premature death.
目的
评估首次发生心房颤动（AF）后痴呆症的发病率及其对社区队列人群生存的影响。
方法与结果
确定明尼苏达州奥姆斯特德县在1986 - 2000年期间被诊断为首次AF的成年居民，并随访至2004年。主要结局是新发痴呆症。分析中对期间发生的中风进行了截尾处理。在2837名（年龄71±15岁）诊断为首次AF且在AF发作时无任何认知功能障碍或中风证据的受试者中，在中位随访4.6年[四分位间距（IQR）范围1.5 - 7.9年]期间，299人被诊断为痴呆症，1638人死亡。痴呆症的Kaplan - Meier累积发生率在1年时为2.7%，5年时为10.5%。在调整年龄和性别后，痴呆症与年龄增长密切相关[风险比（HR）/每10年，2.8；95%置信区间（CI），2.5 - 3.2]，但与性别无关（P = 0.52）。AF后痴呆症的发生与死亡风险显著增加相关（HR 2.9；95% CI 2.5 - 3.3），即使在调整多种合并症后也是如此，且与年龄（P = 0.75）或性别（P = 0.33）无关。
结论
首次诊断AF后痴呆症似乎很常见，且与过早死亡相关。
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