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Arrhythmias & electrophysiology

Effect of atrial fibrillation on progression of cognitive impairment in patients with and without prior stroke

Heart RhythmPublished

  • clinical case series
  • Cox proportional hazards regression
+1 more
  • Cox proportional hazards regression
Read the original article ↗

Authors' conclusion

Important sex-specific differences were observed. AF was associated with cognitive decrease primarily in female patients without prior stroke, whereas prior stroke was a predictor of decrease in male patients regardless of AF status. In women, the association between stroke and cognitive decrease was evident primarily in those without AF. Findings underscore the complex interplay among AF, stroke, and sex in shaping cognitive trajectories and highlight the need for sex-specific risk stratification in patients with AF.

Study context

Population
Participants in the National Alzheimer's Coordinating Center clinical case series, with or without atrial fibrillation (AF) and with or without a stroke historyno AF/no stroke 16,727 · no AF + stroke 548 · AF + no stroke 2,121 · AF + stroke 137
Participants
19,533 participants
Exposure
Associations among AF, stroke history, and cognitive impairment
  • no AF/no stroken = 16,727
  • no AF + stroken = 548
  • AF + no stroken = 2,121
  • AF + stroken = 137

Main finding

As reported in the abstract

Cognitive decrease (advancing from normal to mild cognitive impairment or dementia)
P across groups
P < 0.0001

Observational data: associations, not effects.

Further findings

OutcomeHR
Cognitive decrease, AF vs no AF, women without a stroke history · among subjects without a stroke history1.18 (95% CI 1.00–1.40)
Cognitive decrease, stroke history vs none — Stroke history vs No stroke history · men with AF2.33 (CI [1.31-4.12)
Cognitive decrease, stroke history vs none — Stroke history vs No stroke history · men without AF1.65 (CI 1.09–2.50)
Cognitive decrease, stroke history vs none — Stroke history vs No stroke history · women without AF1.84 (CI 1.43–2.38)

Cognitive decrease, AF vs no AF, women without a stroke history

AF was not associated with cognitive decrease in men

Original publication

Effect of atrial fibrillation on progression of cognitive impairment in patients with and without prior stroke. Heart Rhythm. Published 20 April 2026. doi:10.1016/j.hrthm.2026.04.024
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Summarised from the published abstract; every number is checked against it