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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7407398 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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