Image: A new study shows atrial fibrillation in people with CAD can elevate dementia risk (Photo courtesy of Shutterstock).
A new study suggests that patients with atrial fibrillation (AF) diagnosed with carotid artery disease (CAD) face higher risks for developing dementia.
Researchers at the University of Utah (Salt Lake City, USA) and Intermountain Medical Center (IMC; Salt Lake City, UT, USA) conducted a study that examined 6,786 patients (average age 71.6 years, 55.6% male, 21% with AF) with CAD and without prior history of dementia to determine if the presence of AF is associated with an increased risk of dementia and stroke or transient ischemic attack (TIA). Subsequent analysis was based upon treatment (stent or endarterectomy), with outcomes including dementia and stroke or TIA.
The results revealed that AF increased the risk of dementia, stroke/TIA, and the combination of both, but the associations were attenuated after adjustment by risk factors, comorbidities, and medication use. In patients that received a carotid stent (5,685 patients) dementia rates were 9.4% in the non-AF group versus 9.9% in the AF group. In the group that received an endarterectomy, dementia rates were 8.4% in the non-AF group and 13% in the AF group. The study was presented at the Heart Rhythm Society 39th annual scientific sessions, held during May 2018 in Boston (MA, USA).
“Atrial fibrillation and carotid artery disease are treatable. Neither disease should be accepted passively, and treatment is especially important, given the benefit of helping to prevent or postpone dementia,” said lead author Victoria Jacobs, PhD, of IMC. “Physicians should be discussing the treatment options with patients who are at risk to help educate them about what they can do to live the healthiest life possible. Patients should be engaged in their own healthcare, knowledgeable about their risks, and active in maintaining healthy lifestyles.”
Prior research has shown that the abnormal heart rhythms of AF produce inconsistent blood flow to the brain, which contributes to the onset of dementia or a decrease in cognitive function. Risk factors are similar for AF and CAD and include age, weight, hypertension, high cholesterol, and diabetes. Smoking can also increase risk.
University of Utah
Intermountain Medical Center