Atrial Fibrillation and Cognitive Function JACC Review Topic of the Week

被引：121
|
作者：
Diener, Hans-Christoph [1 ,2 ]
Hart, Robert G. [3 ]
Koudstaal, Peter J. [4 ]
Lane, Deirdre A. [5 ,6 ]
Lip, Gregory Y. H. [5 ,6 ,7 ]
机构：
[1] Univ Hosp Essen, Dept Neurol, Hufelandstr 55, D-45147 Essen, Germany
[2] Univ Duisburg Essen, Hufelandstr 55, D-45147 Duisburg, Germany
[3] McMaster Univ, Populat Hlth Res Inst, Vasc & Stroke Res Inst, Hamilton, ON, Canada
[4] Erasmus MC, Dept Neurol, Rotterdam, Netherlands
[5] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England
[6] Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England
[7] Aalborg Univ, Aalborg Thrombosis Res Unit, Dept Clin Med, Aalborg, Denmark
来源：
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2019年 / 73卷 / 05期
基金：
美国国家卫生研究院;
关键词：
anticoagulation; atrial fibrillation; cognitive impairment; dementia; LONG-TERM RISK; ALZHEIMERS-DISEASE; ORAL ANTICOAGULATION; STROKE PREVENTION; INCIDENT DEMENTIA; THERAPEUTIC RANGE; CARDIAC INDEX; DECLINE; WARFARIN; INFARCTS;
D O I：
10.1016/j.jacc.2018.10.077
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Numerous vascular risk factors and vascular diseases contribute to cognitive impairment and dementia. Many studies and registries show an association of atrial fibrillation (AF) with cognitive impairment, cognitive decline, and dementia. This is true for vascular dementia and Alzheimer's disease. The assumed multifactorial mechanisms include ischemic stroke, both apparent and silent, cerebral microinfarcts, cerebral hemorrhage, and reduced cerebral blood flow. A number of retrospective observational and prospective studies support that anticoagulation in patients with AF may reduce the risk of cognitive decline and dementia. This holds for both vitamin K antagonists (e.g., warfarin) and direct oral anticoagulants. However, it still remains unproven if anticoagulation reduces cognitive decline and dementia in AF patients based on randomized trials. (c) 2019 by the American College of Cardiology Foundation.
引用
收藏
页码：612 / 619
页数：8
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