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Evaluation of the Relationship between Cognitive Impairment and Atria Score Systems in Patients with Atrial

Emre Özdemir1, Ayşen S Ekinci2, Sadık V Emren1

  • 1Department of Cardiology, Ataturk Research and Training Hospital, Izmir Katip Çelebi University, Izmir/Turkey.

Annals of Indian Academy of Neurology
|March 18, 2024
PubMed

Insights

The ATRIA stroke and SAMe-TT2R2 scoring systems show a strong correlation with cognitive impairment in atrial fibrillation (AF) patients, outperforming older scores for better patient monitoring.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Atrial fibrillation (AF) is a primary arrhythmia linked to thromboembolic events and cognitive decline.
  • Cognitive impairment, particularly memory issues, is a significant concern for patients with long-term AF.
  • Existing scoring systems for AF management may not fully capture the risk of cognitive impairment.

Purpose of the Study:

  • To assess the relationship between cognitive impairment and various established scoring systems in AF patients.
  • To identify which scoring systems are most effective in evaluating cognitive status in this population.
  • To enhance the medical follow-up protocols for cognitive impairment in AF patients.

Main Methods:

  • A cohort of 124 AF patients (age 30-80, diagnosed ≥5 years) with memory complaints were studied.
  • Patients were categorized into two groups based on cognitive status (impaired vs. not impaired) using the Mini-Mental State Examination.
  • Correlation analyses were performed between cognitive status and scores including ATRIA bleeding, ATRIA stroke, SAMe-TT2R2, CHADS2, and CHA2DS2-VASc.

Main Results:

  • ATRIA stroke (r=0.738) and SAMe-TT2R2 (r=0.688) scores demonstrated strong correlations with cognitive impairment, unlike CHADS2 and CHA2DS2-VASc.
  • Receiver operating characteristic (ROC) analysis showed high predictive values for ATRIA stroke (AUC=0.930) and SAMe-TT2R2 (AUC=0.895) scores.
  • Both ATRIA stroke and SAMe-TT2R2 scores significantly outperformed CHADS2 and CHA2DS2-VASc in predicting cognitive impairment.

Conclusions:

  • The ATRIA stroke and SAMe-TT2R2 scoring systems are more effective than CHADS2 and CHA2DS2-VASc for assessing cognitive status in AF patients.
  • These validated scoring systems offer improved tools for monitoring cognitive decline in individuals with atrial fibrillation.
  • Implementing these scores can lead to more proactive and effective management of cognitive impairment in AF populations.
Abstract

Keywords:
ATRIA scoreAtrial fibrillationCHA2DS2-VASc scoreSAMe-TT2R2 scorecognitive impairment

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