Dementia in subjects with atrial fibrillation: hemostatic function and the role of anticoagulation

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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

M Barber1, R C Tait, J Scott

  • 1University Section of Clinical Gerontology and Vascular Medicine and Department of Haematology, Royal Infirmary, Glasgow, UK. m.barber@clinmed.gla.ac.uk

Journal of Thrombosis and Haemostasis : JTH
|November 20, 2004
PubMed

Insights

Atrial fibrillation (AF) patients with dementia show higher levels of thrombin generation and fibrin turnover. Long-term warfarin use may offer protection against dementia development in AF patients.

Area of Science:

  • Cardiology
  • Neurology
  • Hematology

Background:

  • Atrial fibrillation (AF) is linked to cognitive decline and dementia.
  • This association may stem from a prothrombotic state and cardioembolism.
  • Investigating hemostatic alterations in AF with dementia is crucial.

Purpose of the Study:

  • To determine if hemostatic function differs in AF patients who develop dementia.
  • To assess if long-term warfarin anticoagulation protects against dementia in AF.
  • To explore the relationship between coagulation markers and cognitive decline in AF.

Main Methods:

  • Observational cohort study of atrial fibrillation (AF) patients.
  • Baseline measurements included plasma fibrinogen, D-dimer, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complexes (TAT), von Willebrand factor, and tissue plasminogen activator.
  • Cognitive function was assessed at 3 years using TICSm and IQCODE.

Main Results:

  • Higher D-dimer, F1+2, and TAT levels were observed in AF subjects with dementia.
  • These findings showed borderline statistical significance after age adjustment.
  • A trend suggested warfarin use was independently associated with reduced dementia prevalence (OR 0.52, P=0.08).

Conclusions:

  • Evidence indicates increased thrombin generation and fibrin turnover in AF patients with dementia.
  • Long-term warfarin therapy may be a protective factor against dementia in individuals with AF.
Abstract

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