Association Between Atrial Fibrillation and Silent Cerebral Infarctions
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in the elderly, currently affecting more than 2.7 million Americans (1), with a projected prevalence of 5.6 to 12.1 million by 2050 (2, 3). Patients with AF have not only a 4- to 5-fold increase in the risk for stroke (4) but also larger brain infarctions and worse poststroke outcomes than patients without AF (57). A recent meta-analysis demonstrated that AF is associated with a 40% increase in the risk for cognitive impairment (relative risk [RR], 1.40 [95% CI, 1.19 to 1.64]) (8). This association was independent of a history of symptomatic stroke (RR, 1.34 [CI, 1.13 to 1.58]) (8) and other comorbid conditions, such as advanced age, hypertension, heart failure, and diabetes (9, 10). These findings highlight the elusiveness of the mechanisms underlying this association and suggest pathways other than symptomatic stroke and shared risk factors listed previously as the underlying cause of this association. One such mechanism may be silent cerebral infarctions (SCIs). Several studies showed a significant association between AF and SCIs in patients without a history of clinically overt stroke (11, 12); however, the few studies that attempted to reproduce similar results did not demonstrate an association (13, 14). There is a significant variability in the reported prevalence of SCIs in patients with AF (11, 12). One source of this heterogeneity may lie in the different methods of diagnosing SCIs. Whereas earlier studies used…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Learning from First-Generation Qualitative Approaches in the IS Discipline: An Evolutionary View and Some Implications for Authors and Evaluators (PART 1/2)
- Commentary on the clinical and preclinical dosage limits of interstitially administered magnetic fluids for therapeutic hyperthermia based on current practice and efficacy models
- Prosthesis: New Technological Opportunities and Innovative Biomedical Devices
- The history and future of neural modeling for cochlear implants
- Ryanodine receptors: waking up from refractoriness
- Novel Transgenic Rabbit Model Sheds Light on the Puzzling Role of Matrix Metalloproteinase-12 in Atherosclerosis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.