Post-procedural anticoagulation enhances cognitive function and reduces stroke risk in atrial fibrillation patients...

To investigate the effect of post-left atrial appendage (LAA) occlusion anticoagulation strategy adjustments on cognitive function in atrial fibrillation (AF) patients, showing the influence of these adjustments on long-term brain health.

In this retrospective cohort study, a total of 210 patients with AF subjected to left atrial appendage (LAA) closure between January 2022 and January 2025 were included. Among them, 103 patients received anticoagulation treatment following the procedure (observation group) and 107 did not (control group). The primary outcome - cognitive function - was evaluated using the Mini-Mental State Examination (MMSE) scale and other cognitive tests. The secondary outcomes, including major adverse events (stroke [ischemic, hemorrhagic], transient ischemic attack, major bleeding, and venous thrombotic event), blood biochemical values (fasting blood glucose [FBG], low-density lipoprotein [LDL], high-density lipoprotein (HDL), triglycerides (TG), prothrombin time [PT], activated partial thromboplastin time [aPTT], fibrinogen, and D-Dimer), and quality-of-life scores (Physical, Mental Health, and Social Functioning) were also recorded and compared between groups.

Post-procedure anticoagulation therapy significantly improved both cognitive function and clinical outcomes in AF patients undergoing LAA occlusion. The observation group demonstrated significantly better performances in the MMSE, attention, working memory, and visual-spatial abilities (all P<0.001). The FBG and LDL levels (both P<0.001) were significantly lower in the observation group compared to the control group, as was the incidence of ischemic stroke (1.9 vs. 5.6%) (P = 0.032). Quality of life scores, including physical, mental, and social functioning, were all significantly better in the observation group (P<0.001). Anticoagulation effects were evident, with significantly prolonged PT and aPTT in the observation group (P<0.001). Logistic regression analysis identified anticoagulation therapy as a significant predictor of reduced cognitive impairment (OR = 0.940, 95% CI: 0.910-0.972, P<0.001), indicating its potential benefit in preserving cognitive function after LAA occlusion.

Post-procedural anticoagulation therapy significantly improves cognitive function, reduces ischemic stroke incidence, and enhances quality of life in AF patients following LAA occlusion, highlighting its clinical value in management.