Evaluation of the Relationship between Cognitive Impairment and Atria Score Systems in Patients with Atrial Fibrillation

Background: Atrial fibrillation (AF) is the main arrhythmia associated with thromboembolic complications and cognitive impairment. In this study, we aimed to evaluate the relationship between cognitive impairment and different scoring systems developed for AF to improve the medical follow-up of cognitive impairment. Methods: Between January 2019 and December 2020, 124 patients between the age of 30 and 80 years, diagnosed with AF for at least 5 years and complaining about memory impairment during cardiological follow-up, were included in the study. The patients were divided into two groups based on their cognitive status as assessed by the Mini-Mental State Examination group 1 consisted of 52 patients with cognitive impairment and group 2 comprised 72 patients without cognitive impairment. Results: The ATRIA bleeding score had a positive moderate correlation ( r = 0.454, P < 0.001), the ATRIA stroke score had a strong correlation ( r = 0.738, P < 0.001), and the SAMe-TT 2 R 2 score had a strong correlation ( r = 0.688, P < 0.001) with cognitive impairment. However, CHADS 2 and CHA 2 DS 2 VASc scores were not statistically correlated with cognitive impairment. According to the receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ATRIA bleeding score was 0.761 with a 95% confidence interval (CI) of 0.678–0.844 and P < 0.001; also, for the ATRIA stroke score, AUC was 0.930 with a 95% CI of 0.886–0.974 and P < 0.001. In addition, for the SAMe-TT 2 R 2 score, AUC was 0.895 with a 95% CI of 0.838–0.952 and P < 0.001. In the pairwise comparison of AUC on ROC curves, the ATRIA stroke score and the SAMe-TT 2 R 2 score were statistically similar ( P = 0.324). ATRIA bleeding, ATRIA stroke, and SAMe-TT 2 R 2 scores were greater than CHADS 2 stroke score ( P : 0.0004, P < 0.0001, and P < 0.0001, respectively), but CHA 2 DS 2 -VASc and CHADS 2 stroke scores were statistically similar ( P : 0.402). Conclusion: Both ATRIA stroke and SAMe-TT 2 R 2 scoring systems can provide a better correlation than CHADS 2 and CHA 2 DS 2 -VASc scores in patients with AF to evaluate their cognitive status. These two scores can be more useful to monitor the patients with AF for medical follow-up of cognitive status.