Arrhythmias & electrophysiologyCohort study
Thromboembolic events and vascular dementia in patients with atrial fibrillation and low apparent stroke risk
- Population-based cohort study
- matched cohort
Authors' conclusion
Death and thromboembolic outcomes, including vascular dementia, are substantially increased in patients with AF despite a lack of conventional stroke risk factors.
Study context
- Population
- UK primary care patients, 2005–2020
- Participants
- 5,199,994 primary care patients
- Exposure
- Atrial fibrillation (AF) with low apparent stroke risk vs matched controls without AF
- AFn = 36,340
- Controln = 117,298reference
Main finding
As reported in the abstract
Incident stroke, arterial thromboembolism, all-cause mortality · 5 years median follow-up
AF
3.8%
Stroke · Arterial thromboembolism 0.3% · All-cause mortality 8.9%
Control
1.5%
Stroke · Arterial thromboembolism 0.1% · All-cause mortality 5.0%
AF vs ControlEstimate (95% CI)P value
stroke
adjusted HR 2.06(1.91–2.21)
P < 0.001arterial thromboembolism
HR 2.39(1.83–3.11)
P < 0.001all-cause mortality
HR 1.44(1.38–1.50)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Dementia (all-cause, vascular, Alzheimer's disease) — AF vs Control · all-cause dementia | 1.17 (1.04–1.32) | P = 0.010 | |
| Dementia (all-cause, vascular, Alzheimer's disease) — AF vs Control · vascular dementia | 1.68 (1.33–2.12) | P < 0.001 | |
| Dementia (all-cause, vascular, Alzheimer's disease) — AF vs Control · Alzheimer's disease | 0.85 (0.70–1.03) | P = 0.09 | |
| 0.512Hazard ratio (log scale) |
Original publication
Thromboembolic events and vascular dementia in patients with atrial fibrillation and low apparent stroke risk. Nat Med. Published 5 June 2024. doi:10.1038/s41591-024-03049-9
Summarised from the published abstract; every number is checked against it