Atrial fibrillation was associated with higher white matter hyperintensity volumes (adjusted mean 0.0046 vs. 0.0034 mL/TIV) and a 4.2-fold increased odds of symptomatic stroke compared to no atrial fibrillation.
Cross-Sectional (n=923)
Is atrial fibrillation associated with increased cerebral small vessel disease markers and stroke risk in older adults?
Atrial fibrillation is associated with a higher burden of cerebral small vessel disease and stroke in older adults, with predictive models showing high accuracy for identifying at-risk patients.
Absolute Event Rate: 0.0046% vs 0.0034%
p-value: p=0.051
Background Atrial fibrillation (AF) and cerebral small vessel disease (CSVD) are prevalent in older adults and may synergistically contribute to cognitive decline and stroke risk. This study investigates the association between AF and CSVD markers, including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), lacunes, and silent brain infarcts, focusing on sex-specific patterns, anticoagulation status, and predictive modeling. Methods In a cross-sectional study of 923 individuals aged ≥70 years undergoing 3.0-Tesla brain MRI, AF was identified via ECG, self-reports, and hospital records. CSVD markers were quantified using standardized MRI protocols. Regression models, adjusted for demographic and vascular risk factors, assessed associations between AF and CSVD markers, stratified by sex, anticoagulation status, and AF onset age. Random Forest and logistic regression models predicted high WMH burden and stroke risk. Results Of 923 participants, 85 (9.2%) had AF. AF was associated with higher WMH volumes (adjusted mean: 0.0046 vs. 0.0034 mL/TIV, p = 0.051; approaching statistical significance), particularly in men ( p = 0.072) and in participants receiving anticoagulation therapy ( p = 0.007). AF increased odds of symptomatic stroke (OR: 4.2, 95% CI: 2.0–8.8), large infarcts, lacunes, and silent infarcts, with stronger effects in men. Frontal lobe CMBs were more prevalent in men with AF (OR: 3.9, p = 0.049). Predictive models showed high accuracy for WMH burden (81.2%, AUC-ROC: 0.88) and stroke (84.9%, AUC-ROC: 0.91). Conclusion AF is independently associated with CSVD, particularly in men and anticoagulated individuals, emphasizing the need for targeted strategies to mitigate AF-related brain injury.
Shang et al. (Wed,) conducted a cross-sectional in Atrial fibrillation and cerebral small vessel disease (n=923). Atrial fibrillation vs. No atrial fibrillation was evaluated on White matter hyperintensity (WMH) volume (mL/TIV) (p=0.051). Atrial fibrillation was associated with higher white matter hyperintensity volumes (adjusted mean 0.0046 vs. 0.0034 mL/TIV) and a 4.2-fold increased odds of symptomatic stroke compared to no atrial fibrillation.