Unrecognized vascular brain lesions linked to cognitive decline in AF

Patients with atrial fibrillation (AF) have an increased risk of cognitive decline, potentially resulting from clinically unrecognized vascular brain lesions, a new Swiss study suggests.

These AF patients have a high burden of clinically “silent” large noncortical or cortical infarcts (LNCCIs), which are associated with poor cognitive function. The multicenter group of investigators administered MRI and cognitive testing to over 1700 AF patients with a mean age of 73 and found LNCCIs in almost one quarter of patients. Roughly one fifth of patients had microbleeds and one fifth had small noncortical infarcts. Almost all patients (99%) had white matter lesions.

Of the 1400 patients who did not have a history of stroke or transient ischemic attack (TIA), clinically silent infarcts were found in 15% of those with LNCCIs and 18% of those with small neocortical infarcts (SNCIs). LNCCIs were found to be the strongest predictor of reduced cognitive performance.

 

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Source: Medscape | 13 March 2019

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