Risk Factor Analysis of Vascular Cognitive Impairment for In-hospital Atrial Fibrillation Patients / 中国循环杂志

ABSTRACT

Objective: To explore the incidence and risk factors of vascular cognitive impairment (VCI) for in-hospital atrial fibrillation (AF) patients. Methods: A total of 303 in-hospital AF patients were studied. Based on MMSE score evaluation, the patients were divided into 2 groups: Non-VCI group, n=216 and VCI group, n=87. The incidence of VCI was assessed and different cognitive functions were studied by uni- and multivariate regression analysis. Results: Compared with Non-VCI group, the patients in VCI group had the elder age, higher proportion of CHA2DS2-VASC score ≥ 2, more with persistent/permanent AF, more combining diabetes and heart failure (HF), more had increased systolic blood pressure, mean arterial pressure, pulse pressure, left atrial (LA) diameter and serum creatinine; less male and decreased left ventricular end-diastolic diameter, P<0.05 and P<0.001. The occurrence rate of VCI for in-hospital patients was 40.3％, with age and CHA2DS2-VASC score increasing, the incidence of VCI was elevating and the occurrence rates in female was higher than male, the patients with persistent/permanent AF was higher than paroxysmal AF, P<0.05 and P<0.001. Multiple linear regression analysis showed that age (OR=-0.1135, 95％ CI -0.1708 to -0.0562, P=0.0001), female (OR=-1.2528, 95％ CI -2.2056 to -0.3000, P=0.0105), education [primary school level (OR=3.2193, 95％ CI 1.844-4.5940, P<0.0001),middle school and above level (OR=5.9104, 95％ CI 4.6055-7.2154, P<0.0001)], HF (OR=-1.9357, 95％ CI -3.5522 to-0.3192, P=0.0196), stroke (OR=-1.6349, 95％ CI -2.7517 to -0.5181, P=0.0044) and LA diameter (OR=-0.1252, 95％ CI-0.1962 to -0.0541, P=0.0006) were related to VCI occurrence in hospitalized AF patients. Conclusion: The incidence of VCI was high in hospitalized AF patients; elder age, female, lower education, HF, stroke and enlarged LA diameter were the risk factors for VCI occurrence in AF patients.