Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Cardiology, University Hospital of Dijon, France.
Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neurology, University Hospital of Dijon, 14 rue Paul Gaffarel, BP 77908, Dijon cedex 21079, France.
Arch Gerontol Geriatr. 2024 Aug;123:105446. doi: 10.1016/j.archger.2024.105446. Epub 2024 Apr 15.
Atrial Fibrillation (AF) is a common cause of ischemic stroke (IS), and is associated with cognitive impairment in the general population. We aimed to compare the prevalence of preexisting cognitive impairment between IS patients with and without AF, and to assess whether prior brain damage could contribute to the observed differences.
Patients with acute IS were prospectively identified from the population-based Dijon Stroke Registry, France. Patients who had a CT-scan as brain imaging modality were included in this analysis to assess the presence of preexisting leukoaraiosis, old vascular brain lesions, and cerebral atrophy. Characteristics of patients including prior-to-stroke cognitive status (normal cognition, mild cognitive impairment (MCI), or dementia) were compared between those with and without AF.
Among 916 IS patients, 288 (31.4 %) had AF, of whom 88 had newly diagnosed AF. AF patients had more frequent prior MCI (17.8 % versus 10.2 %) or dementia (22.4 % versus 13.1 %) (p = 0.001), vascular risk factors, and preexisting brain damage. In unadjusted model, preexisting cognitive impairment was associated with AF (OR=2.24; 95 % CI: 1.49-3.37, p < 0.001 for MCI; OR=2.20; 95 % CI: 1.52-3.18, p < 0.001 for dementia). After adjustment for clinical and imaging variables, preexisting mild cognitive impairment (OR=1.87; 95 % CI: 1.06-3.32, p = 0.032) and dementia (OR=1.98; 95 % CI: 1.15-3.40, p = 0.013) were independently associated with AF.
AF is a common condition in IS patients and is associated with preexisting cognitive impairment. Brain lesions visible on imaging did not seem to fully account for this association that may involve other mechanisms yet to be elucidated.
心房颤动（AF）是缺血性中风（IS）的常见病因，与普通人群的认知障碍有关。我们旨在比较伴有和不伴有 AF 的 IS 患者之间是否存在先前存在的认知障碍，并评估先前的脑损伤是否可能导致观察到的差异。
前瞻性地从法国人群为基础的第戎中风登记处确定患有急性 IS 的患者。对接受 CT 扫描作为脑成像方式的患者进行了这项分析，以评估是否存在先前的脑白质疏松症、陈旧性血管性脑损伤和脑萎缩。比较了伴有和不伴有 AF 的患者的卒中前认知状态（正常认知、轻度认知障碍（MCI）或痴呆）的特征。
在 916 名 IS 患者中，有 288 名（31.4%）患有 AF，其中 88 名患有新发 AF。AF 患者更频繁地患有先前的 MCI（17.8%比 10.2%）或痴呆（22.4%比 13.1%）（p=0.001），伴发更多的血管危险因素和先前存在的脑损伤。在未调整的模型中，先前存在的认知障碍与 AF 相关（OR=2.24；95%CI：1.49-3.37，p<0.001 用于 MCI；OR=2.20；95%CI：1.52-3.18，p<0.001 用于痴呆）。调整临床和影像学变量后，先前存在的轻度认知障碍（OR=1.87；95%CI：1.06-3.32，p=0.032）和痴呆（OR=1.98；95%CI：1.15-3.40，p=0.013）与 AF 独立相关。
AF 是 IS 患者的常见疾病，与先前存在的认知障碍有关。影像学上可见的脑损伤似乎并不能完全解释这种关联，这种关联可能涉及尚未阐明的其他机制。
