Atrial fibrillation and preexisting cognitive impairment in ischemic stroke patients: Dijon Stroke Registry.

Atrial fibrillation Brain CT-scan Ischemic stroke Mild cognitive impairment dementia

Journal

Archives of gerontology and geriatrics
ISSN: 1872-6976
Titre abrégé: Arch Gerontol Geriatr
Pays: Netherlands
ID NLM: 8214379

Informations de publication

Date de publication:
15 Apr 2024
Historique:
received: 24 01 2024
revised: 22 03 2024
accepted: 13 04 2024
medline: 20 4 2024
pubmed: 20 4 2024
entrez: 19 4 2024
Statut: aheadofprint

Résumé

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.

Sections du résumé

BACKGROUND BACKGROUND
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.
METHODS METHODS
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.
RESULTS RESULTS
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.
CONCLUSION CONCLUSIONS
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.

Identifiants

DOI: 10.1016/j.archger.2024.105446 PMID: 38640772
pubmed: 38640772
pii: S0167-4943(24)00122-5
doi: 10.1016/j.archger.2024.105446
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105446

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest Charles Guenancia reports personal fees from MicroPort CRM, Medtronic, Astra-Zeneca, BMS, Pfizer, Abbott, outside the submitted work. Yannick Béjot reports personal fees from BMS, Pfizer, Boehringer-Ingelheim, Medtronic, Amgen, Servier, NovoNordisk, Novartis, outside the submitted work. Other authors: none

Auteurs

Thibaut Pommier (T)

Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Cardiology, University Hospital of Dijon, France.

Gauthier Duloquin (G)

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.

Valentin Pinguet (V)

Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neuroimaging, University Hospital of Dijon, France.

Pierre-Olivier Comby (PO)

Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neuroimaging, University Hospital of Dijon, France.

Charles Guenancia (C)

Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Cardiology, University Hospital of Dijon, France.

Yannick Béjot (Y)

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. Electronic address: yannick.bejot@chu-dijon.fr.

Classifications MeSH