Risk Factors for Dementia in Patients With Atrial Fibrillation.
Risk Factors for Dementia in Patients With Atrial Fibrillation.
复制标题
房颤患者痴呆的危险因素。
DOI：
10.1016/j.amjcard.2022.03.029
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发表时间：
2022-07-01
影响因子：
2.8
通讯作者：
Alonso, Alvaro
中科院分区：
文献类型：
--
作者：
Alam, Aniqa B.;Lutsey, Pamela L.;Chen, Lin Y.;MacLehose, Richard F.;Shao, Iris Y.;Alonso, Alvaro
虽然痴呆和房颤（AF）在老年人中很常见，但AF患者中痴呆的风险因素尚未得到充分表征。我们研究了2007年至2015年在MarketScan商业和医疗保险补充数据库中登记的621，773名AF诊断时无痴呆的AF患者。在门诊和住院患者索赔中，基于ICD-9-CM代码，确定了AF诊断时的痴呆发生率和预测因素（心脏代谢疾病、精神和神经系统疾病、其他慢性疾病），而药物使用情况则基于门诊药房索赔。使用先前建立的算法计算虚弱评分。用多变量考克斯模型评估感兴趣的预测因子与痴呆之间的关联。患者的平均年龄为68岁（SD 14岁），41%为女性。在平均2.0年的随访中，有16，073例痴呆症。痴呆症最强的预测因子是虚弱（HR 1.43，95%CI 1.40，1.45，评分每增加1个标准差），认知障碍（HR 1.50，95%CI 1.36，1.65）、心境障碍（HR 1.49，95%CI 1.32，1.70）、精神分裂症（HR 1.86，95%CI 1.75，1.98）和物质滥用（HR 1.58，95%CI 1.39，1.80）。在心脏代谢疾病中，调整人口统计学、虚弱、合并症和药物后，只有卒中（HR 1.17，95%CI 1.13，1.22）和糖尿病（HR 1.14，95%CI 1.11，1.18）与痴呆风险的小幅增加相关。我们已经确定了AF患者痴呆的几个危险因素。
While dementia and atrial fibrillation (AF) are common in elderly individuals, risk factors for dementia have not been sufficiently characterized in AF patients. We studied 621,773 AF patients without dementia at the time of AF diagnosis enrolled in the MarketScan Commercial and Medicare Supplemental databases from 2007 to 2015. Dementia incidence and presence of predictors at the time of AF diagnosis (cardiometabolic conditions, mental and neurological disorders, other chronic conditions) were based on ICD-9-CM codes in outpatient and inpatient claims, while medication usage was based on outpatient pharmacy claims. A frailty score was calculated using a previously established algorithm. The associations between the predictors of interest and dementia were assessed with multivariable Cox models. Patients had a mean age of 68 years (SD 14 years) and 41% were women. During a mean follow-up of 2.0 years, there were 16,073 cases of dementia. The strongest predictors of dementia were frailty (HR 1.43, 95%CI 1.40, 1.45, per 1-standard deviation increase in the score), cognitive impairment (HR 1.50, 95%CI 1.36, 1.65), mood disorders (HR 1.49, 95%CI 1.32, 1.70), schizophrenia (HR 1.86, 95%CI 1.75, 1.98), and substance abuse (HR 1.58, 95%CI 1.39, 1.80). Among cardiometabolic conditions, only stroke (HR 1.17, 95%CI 1.13, 1.22) and diabetes mellitus (HR 1.14, 95%CI 1.11, 1.18) were associated with small increases in dementia risk after adjusting for demographics, frailty, comorbidities, and medications. We have identified several risk factors for dementia in patients with AF.
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影响因子：
5.4
作者：
Alonso A;Knopman DS;Gottesman RF;Soliman EZ;Shah AJ;O'Neal WT;Norby FL;Mosley TH;Chen LY
通讯作者：
Chen LY
影响因子：
2
作者：
Suanrueang, Passakorn;Shen, Yong-Jiang;Shieh, Fu-An
通讯作者：
Shieh, Fu-An
影响因子：
7.7
作者：
Wandell, Per;Carlsson, Axel C.;Sundquist, Kristina
通讯作者：
Sundquist, Kristina
影响因子：
16.2
作者：
Rawlings, Andreea M.;Sharrett, A. Richey;Selvin, Elizabeth
通讯作者：
Selvin, Elizabeth
影响因子：
7
作者：
Aucott, Lorna S.
通讯作者：
Aucott, Lorna S.