P4–177: Atrial fibrillation and mild cognitive impairment

In patients with arterial hypertension non-valvular atrial fibrillation may raise the risk for mild cognitive impairment despite the use of anticoagulation therapy. 953 patients with arterial hypertension and concomitant cardiovascular risk factors were included in the study. 359 (37.67%) were males and 594 (62.32%) - females. The mean age was 66.05±9.96 years. 130 (13.64%) of them were with non-valvular atrial fibrillation and optimal anticoagulation during the inclusion visit. They underwent neuropsychological testing with Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hachinski ischemic index, Geriatric depression scale and the 4- Instrumental Activities of Daily Living Score. We compared the results from the cognitive impairment screening of the patients with and without atrial fibrillation. The patients with arterial hypertension, concomitant cardiovascular risk factors and atrial fibrillation had significantly (p=0.001 for MoCA and p<0.0001 for MMSE) lower results for the neuropsychological tests than patients with arterial hypertension, concomitant cardiovascular risk factors, but without atrial fibrillation. For the group with atrial fibrillation the mean MoCA result was 23.24±3.39 and the mean MMSE result - 26.59±2,81. For the group without atrial fibrillation the results were higher: MoCA - 24.32±3.54 and MMSE - 27.68±2.32 respectively. The patients with CHADS2 score ≥ 2 were with significantly (p=0.003) lower neuropsychological tests' results than those with CHADS2=1. Hypertensive patient with atrial fibrillation are with elevated risk for mild cognitive impairment. The higher the CHADS2 score result, the higher the risk for cognitive impairment. Mild cognitive impairment should actively be sought in patients with arterial hypertension, concomitant cardio-vascular risk factors and atrial fibrillation.