Eur Heart J:心房颤动是认知能力下降和痴呆的危险因素!

2017-04-30 xing.T MedSci原创

由此可见,在45岁至85岁的成年人中,房颤与加速的认知功能下降有关,即使在房颤发病率较低的年龄,房颤与较高的痴呆的风险相关,至少有部分可以被房颤患者发生的心血管疾病所解释。

近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,在该研究中,为了评估房颤是否是认知功能障碍的危险因素,研究人员使用了从45岁至85岁的成年人房颤、重复认知评分和痴呆症发病率的前瞻性数据进行了分析。

分析数据来自于Whitehall II研究,n=10308,研究参与者招聘始于1985年。研究人员对1997年年龄在45-69岁的7428名参与者(414例房颤患者)进行了4次(1997-2013年期间) 一系列的认知测试。

相比于无房颤参与者,那些长期暴露于房颤的参与者(5、10或15年)经历了更快的认知能力下降,在岁社会人口学、行为与慢性疾病进行调整后(趋势P=0.01)。卒中或冠心病不能单独解释多余的认知能力下降,但是,当将它们放在一起考虑时,这种关系受到了影响(趋势P=0.09)。在调整了社会人口因素、健康行为和慢性疾病后的Cox回归中,对痴呆事件的分析(n=274/9302例无房颤患者;n=50/912例房颤患者)表明房颤与较高的痴呆风险相关[风险比(HR)为1.87;95%可信区间(CI)为1.37-2.55]。在随访中,多态模型显示房颤增加了那些没有卒中患者的痴呆风险(HR为1.67;95%CI为1.17-2.38),但不增加那些没有卒中和冠心病患者的痴呆风险(HR为1.29;95%CI为0.74-2.24)。

由此可见,在45岁至85岁的成年人中,房颤与加速的认知功能下降有关,即使在房颤发病率较低的年龄,房颤与较高的痴呆的风险相关,至少有部分可以被房颤患者发生的心血管疾病所解释。

原始出处:


Archana Singh-Manoux,et al. Atrial fibrillation as a risk factor for cognitive decline and dementia. Eur Heart J.https://doi.org/10.1093/eurheartj/ehx208

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    2017-05-11 flysky120

    学习一下知识了

    0

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    2017-05-09 绛珠草小姐

    学习了,谢谢

    0

  3. 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    2017-05-08 绛珠草小姐

    学习了,谢谢

    0

  4. 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2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193312, encodeId=96f219331226, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOWcPEsEP4FrvDcicue5V6rMkmXmY73KjYP59vQrEdjU89iaN4ZkOhsItlHkmGTjhV3b5S3zOQA4E0/0, createdBy=cc261682151, createdName=卡圣, createdTime=Wed May 03 16:35:32 CST 2017, time=2017-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356252, encodeId=7bea1356252bc, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 01 00:43:39 CST 2017, time=2017-05-01, status=1, ipAttribution=)]
    2017-05-04 ylzr123

    认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。点赞啦!

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 01 00:43:39 CST 2017, time=2017-05-01, status=1, ipAttribution=)]
    2017-05-03 卡圣

    学习了,谢谢分享

    0

  6. 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    2017-05-02 zhaojie88
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  8. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 01 00:43:39 CST 2017, time=2017-05-01, status=1, ipAttribution=)]
    2017-05-02 slcumt
  9. 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    2017-05-02 sodoo
  10. 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    2017-05-01 tanxingdoctor

    学习了谢谢分享

    0

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近日,北京安贞医院杜昕、董建增和马长生教授等在JACC杂志发表综述,认为在人群层面对以下10个问题进行管理,可有效预防房颤的发生。

JAHA:房颤发病率、患病率和死亡率的时间变化趋势!

在大型的一般实践人群中,房颤发病有所增加,然后趋于整体稳定,在年龄≥75年的参与者中持续增加。AF患病率的大幅度增加与房颤相关的合并症的时间变化相关,这表明有必要全面实施房颤预防和管理策略。

Stroke:亚洲房颤患者用CHA2DS2-VASc评分进行卒中危险分层性能如何?

由此可见,亚洲人中CHA2DS2-VASc评分的性能与西方人群相当。该评分在定义真正的卒中/血栓栓塞低风险AF患者上表现出了良好的性能。

J Am Heart Assoc:房颤后华法林抗凝:肾功能不全是否影响结局?

肾功能不全是否会为华法林治疗的房颤患者带来较差的抗凝控制?是否影响相关结局?2017年3月,发表在《J Am Heart Assoc.》的一项研究调查了新诊断为房颤的肾功能不全患者初始华法林后治疗窗内时间和结局。

JAHA:房颤患者达比加群和利伐沙班的安全性和疗效比较!

由此可见,相比于达比加群治疗,利伐沙班治疗与房颤患者全因死亡风险增加相关。