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Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management

Background: Atrial fibrillation (AF) is a risk factor for cerebrovascular diseases and vascular dementia (VAD). The aim of this study was to evaluate the effect of the adherence to anticoagulant therapy guidelines in patients with dementia and AF on the risk of stroke/TIA or major bleeding (MB). Met...

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Autores principales: Viticchi, Giovanna, Falsetti, Lorenzo, Burattini, Marco, Zaccone, Vincenzo, Buratti, Laura, Bartolini, Marco, Moroncini, Gianluca, Silvestrini, Mauro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407398/
https://www.ncbi.nlm.nih.gov/pubmed/32630627
http://dx.doi.org/10.3390/brainsci10070420
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author Viticchi, Giovanna
Falsetti, Lorenzo
Burattini, Marco
Zaccone, Vincenzo
Buratti, Laura
Bartolini, Marco
Moroncini, Gianluca
Silvestrini, Mauro
author_facet Viticchi, Giovanna
Falsetti, Lorenzo
Burattini, Marco
Zaccone, Vincenzo
Buratti, Laura
Bartolini, Marco
Moroncini, Gianluca
Silvestrini, Mauro
author_sort Viticchi, Giovanna
collection PubMed
description Background: Atrial fibrillation (AF) is a risk factor for cerebrovascular diseases and vascular dementia (VAD). The aim of this study was to evaluate the effect of the adherence to anticoagulant therapy guidelines in patients with dementia and AF on the risk of stroke/TIA or major bleeding (MB). Methods: In a cohort of 1705 hospitalized patients with pre-existent AF, we observed 193 patients with vascular dementia (VAD). Non-demented AF patients were included as controls. For each subject, we calculated CHA(2)DS(2)-VASc, CHADS(2), and HAS-BLED scores, and collected information regarding anticoagulant therapy, in-hospital therapeutic failure (TF) occurrence, stroke/TIA, and MB. Results: According to CHA(2)DS(2)-VASc and CHADS(2) scores, 99.5% of VAD patients had the indication to anticoagulant treatment, but only 69.9% were correctly treated. During hospitalization, MB occurred in 4.66% of VAD and 8.9% of non-demented patients (p = 0.048). In-hospital stroke/TIA were observed in 24.3% of VAD and 0.8% of non-demented patients (p = 0.0001). A similar proportion of TF among patients with VAD and with normal cognition (12.9% vs. 11.2%) was observed. Conclusion: In our cohort, we observed that VAD patients with pre-existent AF were undertreated despite a higher risk of stroke/TIA with respect to non-demented patients.
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spelling pubmed-74073982020-08-25 Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management Viticchi, Giovanna Falsetti, Lorenzo Burattini, Marco Zaccone, Vincenzo Buratti, Laura Bartolini, Marco Moroncini, Gianluca Silvestrini, Mauro Brain Sci Article Background: Atrial fibrillation (AF) is a risk factor for cerebrovascular diseases and vascular dementia (VAD). The aim of this study was to evaluate the effect of the adherence to anticoagulant therapy guidelines in patients with dementia and AF on the risk of stroke/TIA or major bleeding (MB). Methods: In a cohort of 1705 hospitalized patients with pre-existent AF, we observed 193 patients with vascular dementia (VAD). Non-demented AF patients were included as controls. For each subject, we calculated CHA(2)DS(2)-VASc, CHADS(2), and HAS-BLED scores, and collected information regarding anticoagulant therapy, in-hospital therapeutic failure (TF) occurrence, stroke/TIA, and MB. Results: According to CHA(2)DS(2)-VASc and CHADS(2) scores, 99.5% of VAD patients had the indication to anticoagulant treatment, but only 69.9% were correctly treated. During hospitalization, MB occurred in 4.66% of VAD and 8.9% of non-demented patients (p = 0.048). In-hospital stroke/TIA were observed in 24.3% of VAD and 0.8% of non-demented patients (p = 0.0001). A similar proportion of TF among patients with VAD and with normal cognition (12.9% vs. 11.2%) was observed. Conclusion: In our cohort, we observed that VAD patients with pre-existent AF were undertreated despite a higher risk of stroke/TIA with respect to non-demented patients. MDPI 2020-07-02 /pmc/articles/PMC7407398/ /pubmed/32630627 http://dx.doi.org/10.3390/brainsci10070420 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Viticchi, Giovanna
Falsetti, Lorenzo
Burattini, Marco
Zaccone, Vincenzo
Buratti, Laura
Bartolini, Marco
Moroncini, Gianluca
Silvestrini, Mauro
Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management
title Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management
title_full Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management
title_fullStr Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management
title_full_unstemmed Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management
title_short Atrial Fibrillation on Patients with Vascular Dementia: A Fundamental Target for Correct Management
title_sort atrial fibrillation on patients with vascular dementia: a fundamental target for correct management
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407398/
https://www.ncbi.nlm.nih.gov/pubmed/32630627
http://dx.doi.org/10.3390/brainsci10070420
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