房颤患者的卒中前痴呆:发病率和相关因素

作     者：Lefebvre C Deplanque D Touzé E. D. Leys 刘凯 

作者机构：Dept. of Neurology University of Lille Roger Salengro Hospital 59037 Lille FranceDr. 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2006年第2卷第5期

页      面：30-31页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100204[医学-神经病学] 10[医学] 

主　　题：急性卒中 房颤患者 痴呆 发病率 NVAF 非瓣膜性房颤 观察性研究 缺血性卒中 发生风险 住院患者 

摘      要：Background and purpose: Prestroke dementia is frequent but usually not identified. Non-valvular atrial fibrillation (NVAF)is independently associated with an increased risk for dementia. However, the frequency and determinants of prestroke dementia in patients with NVAF have never been evaluated. Objective: The aim of this study was to determine the frequency of prestroke dementia and associated factors in patients with a previously known NVAF. Methods: This is an ancillary study of Stroke in Atrial Fibrillation Ensemble II (SAFE II), an observational study conducted in patients with a previously known NVAF, consecutively admitted for an acute stroke in French and Italian centers. Prestroke dementia was evaluated by the IQCODE in patients with a reliable informant. Patients were considered as demented before stroke when their IQCODE score was ≥ 104. Results: of 204 patients, 39 (19.1 % ; 95 % confidence interval [CI]: 13.7 % - 24.5 % ) patients met criteria for prestroke dementia. The only variable independently associated with prestroke dementia was increasing age (adjusted odds ratio for 1 year increase in age: 1.10; 95 % CI: 1.04- 1.17), and there was a non-significant tendency for previous ischemic stroke or TIA and arterial hypertension. Conclusion: One fifth of stroke patients with a previously known NVAF were already demented before stroke. The main determinant of prestroke dementia is increasing age. A large cohort is necessary to identify other determinants.