Arrhythmias & electrophysiologyCohort study
Concussion atrial fibrillation (AF) trial: Longitudinal assessment of brain injury biomarkers and cognitive decline in elderly patients with atrial fibrillation
- Prospective longitudinal study
Authors' conclusion
Over 2 years, dementia incidence was low but 12.5% experienced moderate cognitive decline. Persistent elevations of S100B and SNT145 suggest ongoing subclinical brain injury in patients with anticoagulated AF without acute spikes in traditional stroke markers such as NSE.
Study context
- Population
- Patients with AF without baseline dementia60% completed all visits
- Participants
- 120 patients
- Outcome
- Incident dementia (MMSE score <24 with memory-related quality-of-life impact)
Main finding
As reported in the abstract
Mini-Mental State Examination (MMSE) score of <24 without quality-of-life impact
3
Observational data: associations, not effects.
Secondary outcomes
Comorbidities
- hypertension
- 64.2%
- heart failure
- 23%
- diabetes
- 16%
- sleep apnea
- 30.8%
- previous stroke
- 2
Moderate cognitive decline by ADAS-cog11 (secondary endpoint) · 24 months
- exhibited moderate cognitive decline by ADAS-cog11
- 9 of 72 (12.5%)
S100B · baseline and 24 months
- baseline
- 0.18 ± 0.23 pg/mL
- 24 months
- 0.18 ± 0.19 pg/mL
- persistently elevated
SNT145 · baseline and 24 months
- baseline
- 2.85 ± 3.73 ng/mL
- 24 months
- 2.36 ± 1.86 ng/mL
- elevated
Neuron-specific enolase (NSE), tau and inflammatory markers
- NSE and tau remained within normal ranges
- inflammatory markers were persistently elevated
Correlation of biomarker changes with cognitive decline
- Changes in biomarker levels did not correlate with cognitive decline
Original publication
Summarised from the published abstract; every number is checked against it