Key result
Subclinical atrial fibrillation detected by continuous monitoring and treated with oral anticoagulation was not associated with a significant change in MoCA score over a 3-year period.
Why the study?
The relationship between subclinical AF and changes in cognitive function in individuals with stroke risk factors needed to be evaluated.
Is subclinical AF detected by continuous monitoring and treated with OAC associated with cognitive decline in elderly patients with stroke risk factors?
Cohort (n=1,194)
Is subclinical AF detected by continuous monitoring and treated with OAC associated with cognitive decline in elderly patients with stroke risk factors?
p-value: p=not significant
In elderly patients with stroke risk factors, subclinical AF detected by continuous monitoring and treated with oral anticoagulation is not associated with significant cognitive decline over 3 years.
No association between treated subclinical AF and MoCA decline over 3 years; leaves open whether AF burden drives cognition in untreated high-risk patients.
To study the relationship between subclinical atrial fibrillation (AF) and changes in cognitive function in a large cohort of individuals with stroke risk factors. : Individuals with no prior AF diagnosis but with risk factors for stroke were recruited to undergo annual cognitive assessment with the Montreal Cognitive Assessment (MoCA) along with implantable loop recorder (ILR) monitoring for AF for 3 years. If AF episodes lasting ≥6 minutes were detected, oral anticoagulation (OAC) treatment was initiated. : A total of 1194 participants (55.2 % men, mean age 74.5 (±3.9)) had a combined duration of heart rhythm monitoring of ≈1.3 million days. Among these, 339 participants (28.3%) had adjudicated AF, with a median AF burden of 0.072% (0.02, 0.39), and 324 (96%) initiated OAC. When stratifying the participants into AF burden groups (No AF, AFlow (AF burden <0.25%), and AFhigh, (AF burden >0.25%)), only participants in the AFlow group had a decrease in MoCA score over time (P = .03), although this was not significant after adjustment for stroke risk factors. A subgroup analysis of 175 participants (14.6%) with a MoCA <26 at 3 years found no association to AF diagnosis or burden. : In a high-risk population, subclinical AF detected by continuous monitoring and subsequently treated with OAC was not associated with a significant change in MoCA score over a 3-year period.
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Bonnesen et al. (2021) conducted a cohort in Subclinical atrial fibrillation (n=1,194). Subclinical atrial fibrillation vs. No atrial fibrillation was evaluated on Change in Montreal Cognitive Assessment (MoCA) score (p=not significant). Subclinical atrial fibrillation detected by continuous monitoring and treated with oral anticoagulation was not associated with a significant change in MoCA score over a 3-year period.
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