An analysis of data from the Atherosclerosis Risk in Communities Study reveals the possible association of persistent atrial fibrillation with lower cognitive function. Reviewing a community-based sample of elderly individuals, Lin Yee Chen, MD, MS and colleagues found those with an AF burden of 100% (persistent AF), but not 1% to 6% (paroxysmal AF), had lower executive and verbal cognitive test scores than those without AF. These associations remained significant after adjustment for prevalent clinical stroke and for subclinical cerebral infarcts. The study, authored by University of Minnesota Health Heart Care providers, appears in the Journal of the American College of Cardiology.
Lin Yee Chen, MD, MS, has recently been awarded a National Heart, Lung, and Blood Institute R01 grant to study subclinical atrial fibrillation and AF burden in community-dwelling elderly individuals. The 5-year, $3.74 million multicenter research project will involve 2-week ambulatory heart rhythm monitoring in 4,000 participants. The study seeks to define the role of screening for subclinical AF in the elderly, elucidate the relationship of atherosclerotic risk factors in mild-life to AF burden in older age, and define the prognostic significance of AF burden. This project is an ancillary study to the National Institutes of Health’s ongoing Atherosclerosis Risk in Communities Study.
Improving stroke prediction in AF
A clinical prediction rule used to estimate the risk of stroke in atrial fibrillation patients may gain added accuracy owing to recent research into new risk factors. Lin Yee Chen, MD, MS, and colleagues investigated the predictive utility of adding carotid intima-media thickness and carotid plaque to the clinical prediction rule known as the CHA2DS2-VASc score. The researchers found that both factors were associated with increased risk of ischemic stroke in patients with AF and that the addition of these measures to the CHA2DS2-VASc improved the score’s predictive value. These findings also underscore the importance of treating atherosclerosis and atherosclerotic risk factors to improve outcomes for patients with AF. The study was published in the journal Stroke.
Atrial fibrillation is a serious and growing public health concern. With its incidence expected to double by 2030, risk reduction and coordinated care approaches offer new avenues for managing the condition.Continue reading
Unable to manage his recurrent atrial fibrillation with medication, a patient turns to a targeted ablation procedure. At 1-year follow-up, he remains symptom free and has resumed his normal activities.Continue reading