Evaluation of the Relationship between Cognitive Impairment and Atria Score Systems in Patients with Atrial Fibrillation

Emre Özdemir, A. Ekinci, S. V. Emren, Simge Balaban, M. M. Tiryaki, Mustafa Karaca, Enise N. Özlem Tiryaki, C. Nazlı
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Abstract

Atrial fibrillation (AF) is the main arrhythmia associated with thromboembolic complications and cognitive impairment. In this study, we aimed to evaluate the relationship between cognitive impairment and different scoring systems developed for AF to improve the medical follow-up of cognitive impairment. Between January 2019 and December 2020, 124 patients between the age of 30 and 80 years, diagnosed with AF for at least 5 years and complaining about memory impairment during cardiological follow-up, were included in the study. The patients were divided into two groups based on their cognitive status as assessed by the Mini-Mental State Examination group 1 consisted of 52 patients with cognitive impairment and group 2 comprised 72 patients without cognitive impairment. The ATRIA bleeding score had a positive moderate correlation (r = 0.454, P < 0.001), the ATRIA stroke score had a strong correlation (r = 0.738, P < 0.001), and the SAMe-TT2R2 score had a strong correlation (r = 0.688, P < 0.001) with cognitive impairment. However, CHADS2 and CHA2DS2VASc scores were not statistically correlated with cognitive impairment. According to the receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ATRIA bleeding score was 0.761 with a 95% confidence interval (CI) of 0.678–0.844 and P < 0.001; also, for the ATRIA stroke score, AUC was 0.930 with a 95% CI of 0.886–0.974 and P < 0.001. In addition, for the SAMe-TT2R2 score, AUC was 0.895 with a 95% CI of 0.838–0.952 and P < 0.001. In the pairwise comparison of AUC on ROC curves, the ATRIA stroke score and the SAMe-TT2R2 score were statistically similar (P = 0.324). ATRIA bleeding, ATRIA stroke, and SAMe-TT2R2 scores were greater than CHADS2 stroke score (P: 0.0004, P < 0.0001, and P < 0.0001, respectively), but CHA2DS2-VASc and CHADS2 stroke scores were statistically similar (P: 0.402). Both ATRIA stroke and SAMe-TT2R2 scoring systems can provide a better correlation than CHADS2 and CHA2DS2-VASc scores in patients with AF to evaluate their cognitive status. These two scores can be more useful to monitor the patients with AF for medical follow-up of cognitive status.
评估心房颤动患者认知障碍与心房评分系统之间的关系
心房颤动(房颤)是与血栓栓塞并发症和认知障碍相关的主要心律失常。在这项研究中,我们旨在评估认知障碍与针对房颤开发的不同评分系统之间的关系,以改善认知障碍的医疗随访。 在 2019 年 1 月至 2020 年 12 月期间,研究纳入了 124 名年龄在 30 岁至 80 岁之间、确诊房颤至少 5 年且在心脏病学随访期间抱怨记忆力受损的患者。这些患者被分为两组,第一组包括52名认知障碍患者,第二组包括72名无认知障碍患者。 ATRIA 出血评分与认知障碍呈中度正相关(r = 0.454,P < 0.001),ATRIA 中风评分与认知障碍呈强相关(r = 0.738,P < 0.001),SAMe-TT2R2 评分与认知障碍呈强相关(r = 0.688,P < 0.001)。然而,CHADS2 和 CHA2DS2VASc 评分与认知障碍没有统计学相关性。根据接收者操作特征(ROC)曲线,ATRIA出血评分的曲线下面积(AUC)为0.761,95%置信区间(CI)为0.678-0.844,P<0.001;ATRIA卒中评分的曲线下面积(AUC)为0.930,95%置信区间(CI)为0.886-0.974,P<0.001。此外,SAMe-TT2R2 评分的 AUC 为 0.895,95% CI 为 0.838-0.952,P < 0.001。在 ROC 曲线 AUC 的成对比较中,ATRIA 中风评分和 SAMe-TT2R2 评分在统计学上相似(P = 0.324)。ATRIA出血、ATRIA卒中和SAMe-TT2R2评分均高于CHADS2卒中评分(P:分别为0.0004、P<0.0001和P<0.0001),但CHA2DS2-VASc和CHADS2卒中评分在统计学上相似(P:0.402)。 与 CHADS2 和 CHA2DS2-VASc 评分相比,ATRIA 中风评分系统和 SAMe-TT2R2 评分系统在评估房颤患者的认知状况时能提供更好的相关性。这两个评分系统对监测心房颤动患者的认知状况进行医学随访更有用。
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