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Prevention of Dementia in Patients with Atrial Fibrillation

Atrial fibrillation (AF) is the most common form of arrhythmia in the elderly population and increases stroke risk by a factor of 4- to 5-fold. There is increasing evidence to suggest that incident AF may contribute to the development of dementia, independent of overt stroke. In particular, relative...

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Autores principales: Kim, Daehoon, Yang, Pil-Sung, Joung, Boyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022029/
https://www.ncbi.nlm.nih.gov/pubmed/33821580
http://dx.doi.org/10.4070/kcj.2021.0027
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author Kim, Daehoon
Yang, Pil-Sung
Joung, Boyoung
author_facet Kim, Daehoon
Yang, Pil-Sung
Joung, Boyoung
author_sort Kim, Daehoon
collection PubMed
description Atrial fibrillation (AF) is the most common form of arrhythmia in the elderly population and increases stroke risk by a factor of 4- to 5-fold. There is increasing evidence to suggest that incident AF may contribute to the development of dementia, independent of overt stroke. In particular, relatively younger patients with AF are more prone to dementia development than older patients with AF. Evidence is accumulating regarding the possible treatment strategies for preventing dementia in patients with AF. Oral anticoagulation may be effective for reducing the risk of dementia, even in patients with low stroke risks. Among oral anticoagulants, the use of non-vitamin K antagonists have been associated with a considerably decreased risk of dementia than warfarin. Moreover, successful catheter ablation for AF has also been associated with decreased dementia risk compared to medical therapy, suggesting that restoration of sinus rhythm, and not the ablation procedure itself, as the important mechanism in the prevention of AF-associated dementia. Among midlife patients with AF, there appeared to be a U-shaped association of blood pressure (BP) and a linear association of hypertension with dementia risk. A BP of 120 to 129/80 to 84 mmHg has been identified as the optimal range. Finally, integrated management of AF was associated with a reduced risk of dementia in AF patients.
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spelling pubmed-80220292021-04-13 Prevention of Dementia in Patients with Atrial Fibrillation Kim, Daehoon Yang, Pil-Sung Joung, Boyoung Korean Circ J State of the Art Review Atrial fibrillation (AF) is the most common form of arrhythmia in the elderly population and increases stroke risk by a factor of 4- to 5-fold. There is increasing evidence to suggest that incident AF may contribute to the development of dementia, independent of overt stroke. In particular, relatively younger patients with AF are more prone to dementia development than older patients with AF. Evidence is accumulating regarding the possible treatment strategies for preventing dementia in patients with AF. Oral anticoagulation may be effective for reducing the risk of dementia, even in patients with low stroke risks. Among oral anticoagulants, the use of non-vitamin K antagonists have been associated with a considerably decreased risk of dementia than warfarin. Moreover, successful catheter ablation for AF has also been associated with decreased dementia risk compared to medical therapy, suggesting that restoration of sinus rhythm, and not the ablation procedure itself, as the important mechanism in the prevention of AF-associated dementia. Among midlife patients with AF, there appeared to be a U-shaped association of blood pressure (BP) and a linear association of hypertension with dementia risk. A BP of 120 to 129/80 to 84 mmHg has been identified as the optimal range. Finally, integrated management of AF was associated with a reduced risk of dementia in AF patients. The Korean Society of Cardiology 2021-03-11 /pmc/articles/PMC8022029/ /pubmed/33821580 http://dx.doi.org/10.4070/kcj.2021.0027 Text en Copyright © 2021. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle State of the Art Review
Kim, Daehoon
Yang, Pil-Sung
Joung, Boyoung
Prevention of Dementia in Patients with Atrial Fibrillation
title Prevention of Dementia in Patients with Atrial Fibrillation
title_full Prevention of Dementia in Patients with Atrial Fibrillation
title_fullStr Prevention of Dementia in Patients with Atrial Fibrillation
title_full_unstemmed Prevention of Dementia in Patients with Atrial Fibrillation
title_short Prevention of Dementia in Patients with Atrial Fibrillation
title_sort prevention of dementia in patients with atrial fibrillation
topic State of the Art Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022029/
https://www.ncbi.nlm.nih.gov/pubmed/33821580
http://dx.doi.org/10.4070/kcj.2021.0027
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