导管切除与保持认知功能有关吗? 来自SAGE-AF观测队列研究的分析
Bahadar S Srichawla1, Alexander P Hamel2, Philip Cook2
1Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, U.S.A.
medRxiv : the preprint server for health sciences
|December 4, 2023
概括
与医疗管理相比,老年人对心房动 (AF) 的导管切除 (CA) 与两年内认知障碍的风险较低有关. 这表明CA可能有助于在这个人群中保持认知功能.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 神经学 神经学
背景情况:
- 心房动 (AF) 在老年人中很常见,并与认知障碍的风险增加有关.
- 导管切除 (CA) 是AF的治疗选择,但其对认知功能的长期影响尚未完全理解.
研究的目的:
- 调查导管切除 (CA) 与老年AF患者医疗管理和认知障碍之间的关联.
- 为了确定CA治疗是否会影响AF患者认知能力下降的进展.
主要方法:
- 一项纵向前性队列研究 (SAGE-AF) 在2016-2018年期间招募了887名65岁以上的外科医院患者.
- 认知功能每年使用蒙特利尔认知评估 (MoCA) 工具评估两年,损伤定义为MoCA ≤23.
- 多变量调整后勤回归分析了CA和认知障碍之间的关联,控制了潜在的混因素.
主要成果:
- 在入学前接受CA的参与者 (n=193) 与接受医疗管理的人 (调整后几率比率为0.70) 相比,两年内认知障碍的可能性显著降低.
- 在为期两年的随访中,CA组的30.1%患有认知障碍,而非CA组的44.8% (p=0.0002).
- 参与者的平均年龄为75.2岁,其中48.6%是女性,87.4%是非西班牙裔白人.
结论:
- 老年人中心房动的导管切除与两年内认知障碍的发病率降低有关.
- 这些发现表明,CA可能对AF的老年患者的认知功能产生保护作用.
- 需要进一步的研究来阐明这种关联背后的机制.
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