Association Between Relevant Co-Morbidities and Dementia With Atrial Fibrillation-A National Study
Association Between Relevant Co-Morbidities and Dementia With Atrial Fibrillation-A National Study
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DOI：
10.1016/j.arcmed.2019.05.007
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发表时间：
2019-02-01
影响因子：
7.7
通讯作者：
Sundquist, Kristina
中科院分区：
文献类型：
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作者：
Wandell, Per;Carlsson, Axel C.;Sundquist, Kristina
背景房颤（AF）患者发生痴呆的风险增加。研究AF患者的相关合并症和突发痴呆（血管性痴呆、阿尔茨海默病、其他痴呆和所有痴呆）。方法。纳入了1998-2012年在瑞典医院诊断为AF的所有≥ 45岁成人（n = 537，513）。考克斯回归用于估计合并症和痴呆事件之间相关性的风险比（HR）和95%CI，校正年龄、瑞典居住地和社会经济因素后。在随访期间，共有30，332名患者（5.6%）被诊断患有痴呆症，其中14，097名男性（4.9%）和16，235名女性（6.5%）。调整后（人力资源; 95%CI），高血压与男性（0.79; 0.76-0.82）和女性（0.77; 0.74-0.79）痴呆（所有类型）的发病风险较低相关。患有中风、糖尿病、抑郁症和焦虑症的患者患痴呆症的风险更高。在伴有冠心病和充血性心力衰竭的房颤患者中，痴呆的风险也较低。由于可能的“生存偏差”或反向因果关系，需要非常谨慎地解释关于偶发性痴呆的发现。然而，与高血压相关的痴呆的相关风险较低可能是由某些抗高血压药物的保护作用解释的。(C)2019年IMSS。由爱思唯尔公司出版
Background. The risk of dementia is increased in patients with atrial fibrillation (AF).Objective. To study relevant co-morbidities and incident dementia (vascular dementia, Alzheimers disease, other dementia and all dementia) in AF patients.Methods. All adults (n = 537,513) >= 45 years diagnosed with AF in hospitals in Sweden 1998-2012 were included. Cox regression was used to estimate hazard ratios (HR) with 95% CIs for association between co-morbidities, and incident dementia, after adjustment for age, residence place in Sweden, and socio-economic factors.Results. Totally 30,332 patients (5.6%) were diagnosed with dementia during the follow-up, with 14,097 men (4.9%) and 16,235 women (6.5%). After adjustments (HRs; 95% CI), hypertension was associated with lower risk of incident dementia (all types) in men (0.79; 0.76-0.82) and women (0.77; 0.74-0.79). Higher risk of dementia was seen in patients with stroke, diabetes, depression and anxiety. Lower risks of dementia were also seen in AF patients with concomitant coronary heart disease and congestive heart failure.Conclusions. The findings regarding incident dementia need to be interpreted with great caution, owing to possible "survival bias" or reversed causation. However, the lower associated risks of dementia associated with hypertension could possibly be explained by protective effects of certain antihypertensive drugs. (C) 2019 IMSS. Published by Elsevier Inc.