Stroke: Relationship between atrial fibrillation and cognitive dysfunction in stroke patients

Atrial fibrillation (AF) is the most common chronic arrhythmiaDementia and cognitive impairment (CI) are the main burden of public healthThe prevalence of these three diseases is expected to increase as an ageing population agesPrevious reports have linked AF to an increased risk of CI and dementia in patients without prior strokeStudies have identified stroke as increasing the risk of dementia and CIIt is not clear whether AF in stroke patients will further increase the risk of dementia or CIIn a recent study published in the journal Stroke, an authoritative journal on cardiovascular disease, researchers looked at the effects of AF on dementia or CI risk in stroke patientsresearchers searched databases such as The Pubmed, Scopus and Cochrane Centers, with outcomes of interest including dementia, CI, and the compound endpoint of dementia or CIThe researchers conducted a meta-analysis of random effect models and meta regression analysisThe researchers used the Egger test and funnel chart to assess the bias in publicationthe meta-analysis included 14 studies involving 14,360 patients (1363 AF patients)In a meta-analysis of the correction ratio, AF and CI (ratio of 1.60 (95% CI is 1.20-1.24),dementia (ratio of 3.11 (95% CI is 2.05-4.73)) and the compound endpoint of CI or dementia (ratio of 2.26 (95% CI 1.61-39) are associated with an increaseThe heterogeneousness of dementia or CI compound endpoints is medium (correction analysis)The heterogeneity of CI endpoint analysis is only significant in unadjusted analysis, while medium in adjusted analysisThe heterogeneity of the end point of dementia was only moderate in unadjusted analysis and zero in the adjusted analysisthus shows that the correlation between AF and CI or dementia in patients with prior stroke may be a persistent positive correlation in unadjusted and adjusted analysisThe level of heterogeneity limits the certainty of these results