心房颤动与痴呆风险：流行病学、机制及抗凝作用
Atrial Fibrillation and Risk of Dementia: Epidemiology, Mechanisms, and Effect of Anticoagulation.
作者信息
Silva Rose Mary Ferreira Lisboa Da, Miranda Cláudia Madeira, Liu Tong, Tse Gary, Roever Leonardo
机构信息
Department of Internal Medicine, Federal Institute of Minas Gerais, Belo Horizonte, Brazil.
Department of Cardiology, Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, China.
出版信息
Front Neurosci. 2019 Jan 31;13:18. doi: 10.3389/fnins.2019.00018. eCollection 2019.
Abstract
Atrial fibrillation (AF) is one of the cardiovascular risk factors for dementia. Several longitudinal studies have reported an association between AF and dementia independently of stroke history. Although the mechanisms underlying this association are not fully understood, proposed mechanisms include cerebral hypoperfusion, inflammation, genetic factors, cerebral microbleeds, and recurrent silent cerebral ischemia. Oral anticoagulation can be used to minimize risk of cognitive decline and dementia, given that brain insults can be caused by chronic microemboli or microbleeds. However, controversy on the effects of warfarin and direct oral anticoagulants on this risk exists. This article will address these aspects, with data on the studies already published and a critical view on this subject.
摘要
心房颤动（AF）是痴呆症的心血管危险因素之一。多项纵向研究报告了AF与痴呆症之间的关联，且独立于中风病史。尽管这种关联背后的机制尚未完全了解，但提出的机制包括脑灌注不足、炎症、遗传因素、脑微出血和复发性无症状性脑缺血。鉴于慢性微栓子或微出血可导致脑损伤，口服抗凝药可用于将认知衰退和痴呆症的风险降至最低。然而，华法林和直接口服抗凝剂对这种风险的影响存在争议。本文将探讨这些方面，介绍已发表研究的数据，并对该主题进行批判性审视。
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