Özdemir Emre, Ekinci Ayşen S, Emren Sadık V, Balaban Simge, Tiryaki Muhammet M, Karaca Mustafa, Tiryaki Enise N Özlem, Nazlı Cem
Department of Cardiology, Ataturk Research and Training Hospital, Izmir Katip Çelebi University, Izmir/Turkey.
Department of Neurology, Ataturk Research and Training Hospital, Izmir Katip Çelebi University, Izmir/Turkey.
Ann Indian Acad Neurol. 2024 Jan-Feb;27(1):46-52. doi: 10.4103/aian.aian_674_23. Epub 2024 Feb 1.
Atrial fibrillation (AF) is the main arrhythmia associated with thromboembolic complications and cognitive impairment. In this study, we aimed to evaluate the relationship between cognitive impairment and different scoring systems developed for AF to improve the medical follow-up of cognitive impairment.
Between January 2019 and December 2020, 124 patients between the age of 30 and 80 years, diagnosed with AF for at least 5 years and complaining about memory impairment during cardiological follow-up, were included in the study. The patients were divided into two groups based on their cognitive status as assessed by the Mini-Mental State Examination group 1 consisted of 52 patients with cognitive impairment and group 2 comprised 72 patients without cognitive impairment.
The ATRIA bleeding score had a positive moderate correlation ( = 0.454, < 0.001), the ATRIA stroke score had a strong correlation ( = 0.738, < 0.001), and the SAMe-TTR score had a strong correlation ( = 0.688, < 0.001) with cognitive impairment. However, CHADS and CHADSVASc scores were not statistically correlated with cognitive impairment. According to the receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ATRIA bleeding score was 0.761 with a 95% confidence interval (CI) of 0.678-0.844 and < 0.001; also, for the ATRIA stroke score, AUC was 0.930 with a 95% CI of 0.886-0.974 and < 0.001. In addition, for the SAMe-TTR score, AUC was 0.895 with a 95% CI of 0.838-0.952 and < 0.001. In the pairwise comparison of AUC on ROC curves, the ATRIA stroke score and the SAMe-TTR score were statistically similar ( = 0.324). ATRIA bleeding, ATRIA stroke, and SAMe-TTR scores were greater than CHADS stroke score (: 0.0004, < 0.0001, and < 0.0001, respectively), but CHADS-VASc and CHADS stroke scores were statistically similar (: 0.402).
Both ATRIA stroke and SAMe-TTR scoring systems can provide a better correlation than CHADS and CHADS-VASc scores in patients with AF to evaluate their cognitive status. These two scores can be more useful to monitor the patients with AF for medical follow-up of cognitive status.
心房颤动（AF）是与血栓栓塞并发症和认知障碍相关的主要心律失常。在本研究中，我们旨在评估认知障碍与为房颤开发的不同评分系统之间的关系，以改善对认知障碍的医学随访。
在2019年1月至2020年12月期间，124名年龄在30至80岁之间、被诊断为房颤至少5年且在心脏科随访期间抱怨有记忆障碍的患者被纳入研究。根据简易精神状态检查表评估的认知状态，将患者分为两组：第1组由52名有认知障碍的患者组成，第2组由72名无认知障碍的患者组成。
ATRIA出血评分与认知障碍呈中度正相关（=0.454，<0.001），ATRIA卒中评分与认知障碍呈强相关（=0.738，<0.001），SAMe-TTR评分与认知障碍呈强相关（=0.688，<0.001）。然而，CHADS和CHADSVASc评分与认知障碍无统计学相关性。根据受试者工作特征（ROC）曲线，ATRIA出血评分的曲线下面积（AUC）为0.761，95%置信区间（CI）为0.678 - 0.844，<0.001；同样，ATRIA卒中评分的AUC为0.930，95%CI为0.886 - 0.974，<0.001。此外，SAMe-TTR评分的AUC为0.895，95%CI为0.838 - 0.952，<0.001。在ROC曲线上AUC的两两比较中，ATRIA卒中评分和SAMe-TTR评分在统计学上相似（=0.324）。ATRIA出血、ATRIA卒中和SAMe-TTR评分均高于CHADS卒中评分（分别为：0.0004，<0.0001，<0.0001），但CHADS-VASc和CHADS卒中评分在统计学上相似（=0.402）。
在房颤患者中，ATRIA卒中和SAMe-TTR评分系统在评估认知状态方面比CHADS和CHADS-VASc评分具有更好的相关性。这两个评分在监测房颤患者认知状态的医学随访中可能更有用。
