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Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study

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Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study. / Malavasi, Vincenzo Livio; Zoccali, Cristina; Brandi, Maria Chiara; Micali, Giulia; Vitolo, Marco; Imberti, Jacopo Francesco; Mussi, Chiara; Schnabel, Renate B; Freedman, Ben; Boriani, Giuseppe.

In: INT J CARDIOL, Vol. 323, 15.01.2021, p. 83-89.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Malavasi, VL, Zoccali, C, Brandi, MC, Micali, G, Vitolo, M, Imberti, JF, Mussi, C, Schnabel, RB, Freedman, B & Boriani, G 2021, 'Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study', INT J CARDIOL, vol. 323, pp. 83-89. https://doi.org/10.1016/j.ijcard.2020.08.028

APA

Malavasi, V. L., Zoccali, C., Brandi, M. C., Micali, G., Vitolo, M., Imberti, J. F., Mussi, C., Schnabel, R. B., Freedman, B., & Boriani, G. (2021). Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study. INT J CARDIOL, 323, 83-89. https://doi.org/10.1016/j.ijcard.2020.08.028

Vancouver

Malavasi VL, Zoccali C, Brandi MC, Micali G, Vitolo M, Imberti JF et al. Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study. INT J CARDIOL. 2021 Jan 15;323:83-89. https://doi.org/10.1016/j.ijcard.2020.08.028

Bibtex

@article{8fbb4521b21541838ab78c94b40321dd,
title = "Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study",
abstract = "BACKGROUND: The impact of cognitive status on outcomes of patients with atrial fibrillation (AF) is not well defined.AIMS: To assess the prevalence of cognitive impairment in AF patients and evaluate its association with: i) all-cause mortality; ii) a composite endpoint of death, stroke/systemic embolism, hemorrhages, acute coronary syndrome, pulmonary embolism, new/worsening heart failure.METHODS: In a cohort study, cognitive status was assessed at baseline by the Mini Mental State examination adjusted for age and education (aMMSE). aMMSE <24 was considered indicative of cognitive impairment.RESULTS: The cohort included 437 patients (61.3% male, mean age 73.4 ± 11.7 years). Sixty-three patients (14.4%) had cognitive impairment at baseline aMMSE. Permanent AF (odds ratio [OR] 1.750; 95%CI 1.012-3.025; p = .045), haemoglobin levels (OR 0.827; 95%CI 0.707-0.967; p = .017) and previous treatment with antiplatelet drugs only, without oral anticoagulation, (OR 4.352; 95%CI 1.583-11.963; p = .004) were independently associated with cognitive impairment at baseline. After a median follow-up of 887 days (interquartile range 731-958) 30 patients died (7.1%), and 97 (22.9%) reached the composite endpoint. After adjustment for Elixhauser Comorbidy Measure, aMMSE <24 was significantly associated with all-cause mortality (hazard ratio [HR] 2.473, 95%CI 1.062-5.756, p = .036) and with the composite endpoint (HR 1.852, 95%CI 1.106-3.102, p = .019).CONCLUSIONS: In patients with AF, cognitive impairment (aMMSE <24) is associated with worse outcomes, and the association of adverse outcomes with previous treatment with antiplatelet drugs only, without oral anticoagulation, highlights the potential role of appropriate antithrombotic treatment for improving patient prognosis.",
keywords = "Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation/diagnosis, Cognitive Dysfunction/diagnosis, Cohort Studies, Female, Humans, Male, Middle Aged, Risk Factors, Stroke",
author = "Malavasi, {Vincenzo Livio} and Cristina Zoccali and Brandi, {Maria Chiara} and Giulia Micali and Marco Vitolo and Imberti, {Jacopo Francesco} and Chiara Mussi and Schnabel, {Renate B} and Ben Freedman and Giuseppe Boriani",
note = "Copyright {\textcopyright} 2020 The Authors. Published by Elsevier B.V. All rights reserved.",
year = "2021",
month = jan,
day = "15",
doi = "10.1016/j.ijcard.2020.08.028",
language = "English",
volume = "323",
pages = "83--89",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study

AU - Malavasi, Vincenzo Livio

AU - Zoccali, Cristina

AU - Brandi, Maria Chiara

AU - Micali, Giulia

AU - Vitolo, Marco

AU - Imberti, Jacopo Francesco

AU - Mussi, Chiara

AU - Schnabel, Renate B

AU - Freedman, Ben

AU - Boriani, Giuseppe

N1 - Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

PY - 2021/1/15

Y1 - 2021/1/15

N2 - BACKGROUND: The impact of cognitive status on outcomes of patients with atrial fibrillation (AF) is not well defined.AIMS: To assess the prevalence of cognitive impairment in AF patients and evaluate its association with: i) all-cause mortality; ii) a composite endpoint of death, stroke/systemic embolism, hemorrhages, acute coronary syndrome, pulmonary embolism, new/worsening heart failure.METHODS: In a cohort study, cognitive status was assessed at baseline by the Mini Mental State examination adjusted for age and education (aMMSE). aMMSE <24 was considered indicative of cognitive impairment.RESULTS: The cohort included 437 patients (61.3% male, mean age 73.4 ± 11.7 years). Sixty-three patients (14.4%) had cognitive impairment at baseline aMMSE. Permanent AF (odds ratio [OR] 1.750; 95%CI 1.012-3.025; p = .045), haemoglobin levels (OR 0.827; 95%CI 0.707-0.967; p = .017) and previous treatment with antiplatelet drugs only, without oral anticoagulation, (OR 4.352; 95%CI 1.583-11.963; p = .004) were independently associated with cognitive impairment at baseline. After a median follow-up of 887 days (interquartile range 731-958) 30 patients died (7.1%), and 97 (22.9%) reached the composite endpoint. After adjustment for Elixhauser Comorbidy Measure, aMMSE <24 was significantly associated with all-cause mortality (hazard ratio [HR] 2.473, 95%CI 1.062-5.756, p = .036) and with the composite endpoint (HR 1.852, 95%CI 1.106-3.102, p = .019).CONCLUSIONS: In patients with AF, cognitive impairment (aMMSE <24) is associated with worse outcomes, and the association of adverse outcomes with previous treatment with antiplatelet drugs only, without oral anticoagulation, highlights the potential role of appropriate antithrombotic treatment for improving patient prognosis.

AB - BACKGROUND: The impact of cognitive status on outcomes of patients with atrial fibrillation (AF) is not well defined.AIMS: To assess the prevalence of cognitive impairment in AF patients and evaluate its association with: i) all-cause mortality; ii) a composite endpoint of death, stroke/systemic embolism, hemorrhages, acute coronary syndrome, pulmonary embolism, new/worsening heart failure.METHODS: In a cohort study, cognitive status was assessed at baseline by the Mini Mental State examination adjusted for age and education (aMMSE). aMMSE <24 was considered indicative of cognitive impairment.RESULTS: The cohort included 437 patients (61.3% male, mean age 73.4 ± 11.7 years). Sixty-three patients (14.4%) had cognitive impairment at baseline aMMSE. Permanent AF (odds ratio [OR] 1.750; 95%CI 1.012-3.025; p = .045), haemoglobin levels (OR 0.827; 95%CI 0.707-0.967; p = .017) and previous treatment with antiplatelet drugs only, without oral anticoagulation, (OR 4.352; 95%CI 1.583-11.963; p = .004) were independently associated with cognitive impairment at baseline. After a median follow-up of 887 days (interquartile range 731-958) 30 patients died (7.1%), and 97 (22.9%) reached the composite endpoint. After adjustment for Elixhauser Comorbidy Measure, aMMSE <24 was significantly associated with all-cause mortality (hazard ratio [HR] 2.473, 95%CI 1.062-5.756, p = .036) and with the composite endpoint (HR 1.852, 95%CI 1.106-3.102, p = .019).CONCLUSIONS: In patients with AF, cognitive impairment (aMMSE <24) is associated with worse outcomes, and the association of adverse outcomes with previous treatment with antiplatelet drugs only, without oral anticoagulation, highlights the potential role of appropriate antithrombotic treatment for improving patient prognosis.

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants

KW - Atrial Fibrillation/diagnosis

KW - Cognitive Dysfunction/diagnosis

KW - Cohort Studies

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Stroke

U2 - 10.1016/j.ijcard.2020.08.028

DO - 10.1016/j.ijcard.2020.08.028

M3 - SCORING: Journal article

C2 - 32800908

VL - 323

SP - 83

EP - 89

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

ER -