Atrial Fibrillation (AF) is a common cause of ischemic stroke (IS), and is associated with cognitive impairment in the general population. We aimed to compare the prevalence of preexisting cognitive impairment between IS patients with and without AF, and to assess whether prior brain damage could contribute to the observed differences. Patients with acute IS were prospectively identified from the population-based Dijon Stroke Registry, France. Patients who had a CT-scan as brain imaging modality were included in this analysis to assess the presence of preexisting leukoaraiosis, old vascular brain lesions, and cerebral atrophy. Characteristics of patients including prior-to-stroke cognitive status (normal cognition, mild cognitive impairment (MCI), or dementia) were compared between those with and without AF. Among 916 IS patients, 288 (31.4 %) had AF, of whom 88 had newly diagnosed AF. AF patients had more frequent prior MCI (17.8 % versus 10.2 %) or dementia (22.4 % versus 13.1 %) ( = 0.001), vascular risk factors, and preexisting brain damage. In unadjusted model, preexisting cognitive impairment was associated with AF (OR=2.24; 95 % CI: 1.49–3.37, < 0.001 for MCI; OR=2.20; 95 % CI: 1.52–3.18, < 0.001 for dementia). After adjustment for clinical and imaging variables, preexisting mild cognitive impairment (OR=1.87; 95 % CI: 1.06–3.32, = 0.032) and dementia (OR=1.98; 95 % CI: 1.15–3.40, = 0.013) were independently associated with AF. AF is a common condition in IS patients and is associated with preexisting cognitive impairment. Brain lesions visible on imaging did not seem to fully account for this association that may involve other mechanisms yet to be elucidated.

中文翻译：

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缺血性中风患者的心房颤动和先前存在的认知障碍：第戎中风登记处

心房颤动 (AF) 是缺血性中风 (IS) 的常见原因，并且与普通人群的认知障碍有关。我们的目的是比较患有和不患有 AF 的 IS 患者之间先前存在的认知障碍的患病率，并评估先前的脑损伤是否会导致观察到的差异。急性 IS 患者是从法国第戎中风登记处前瞻性确定的。本次分析纳入了接受 CT 扫描作为脑成像方式的患者，以评估是否存在先前存在的脑白质疏松、陈旧性脑血管病变和脑萎缩。比较患有和不患有房颤的患者的特征，包括卒中前的认知状态（正常认知、轻度认知障碍（MCI）或痴呆）。在 916 名 IS 患者中，288 名（31.4%）患有房颤，其中 88 名新诊断房颤。 AF 患者既往有更频繁的 MCI（17.8% 对比 10.2%）或痴呆（22.4% 对比 13.1%）(= 0.001)、血管危险因素和先前存在的脑损伤。在未经调整的模型中，先前存在的认知障碍与 AF 相关（对于 MCI，OR=2.24；95% CI：1.49–3.37，< 0.001；对于痴呆，OR=2.20；95% CI：1.52–3.18，< 0.001）。调整临床和影像变量后，先前存在的轻度认知障碍（OR=1.87；95% CI：1.06–3.32，= 0.032）和痴呆（OR=1.98；95% CI：1.15–3.40，= 0.013）与AF。 AF 是 IS 患者的常见病症，与先前存在的认知障碍有关。成像上可见的脑部病变似乎并不能完全解释这种关联，可能涉及其他尚未阐明的机制。