2004
DOI: 10.1111/j.1538-7836.2004.00993.x
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Dementia in subjects with atrial fibrillation: hemostatic function and the role of anticoagulation

Abstract: See also Pengo V. Long-term warfarin use to prevent both stroke and dementia in subjects with atrial fibrillation? This issue, pp 1871-2.Summary. Background: Atrial fibrillation (AF) is associated with cognitive impairment and dementia, perhaps through encouraging a prothrombotic state and cardioembolism. Objectives: We wished to test the hypotheses that hemostatic function is altered in subjects with AF who develop dementia, and that long-term warfarin anticoagulation is protective against this complication. … Show more

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Cited by 111 publications
(71 citation statements)
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“…Our previous study experience of telephone contact suggested that it should be possible to gather cognitive data on around 74% of available participants [16]. The acceptance rate in this study for telephone interview was similar to our previous experience but we are considering how this percentage might be increased without pressurising participants.…”
Section: Discussionsupporting
confidence: 55%
See 1 more Smart Citation
“…Our previous study experience of telephone contact suggested that it should be possible to gather cognitive data on around 74% of available participants [16]. The acceptance rate in this study for telephone interview was similar to our previous experience but we are considering how this percentage might be increased without pressurising participants.…”
Section: Discussionsupporting
confidence: 55%
“…Our previous study experience of telephone contact suggested that it should be possible to gather cognitive data on around 74% of available participants [16]. Therefore we estimated obtaining information on 97 in our pilot of 300 PROSPER participants.…”
Section: Data Analysis and Statistical Methodsmentioning
confidence: 99%
“…142 Hypothesized pathophysiological mechanisms include cerebral hypoperfusion, 143 microembolization, 144 inflammation, and platelet dysfunction. 145 Unfortunately 141,146 Consequently, the pathogenitic role of microemboli is uncertain, given the observation that antithrombotic therapy did not modify the association between AF and cognitive decline in these studies.…”
Section: Cognitive Dysfunctionmentioning
confidence: 99%
“…Researchers have formulated different explanations for the higher mortality in patients with CI: CI may interfere with treatment compliance [33]; cognitive deficits may be a marker of a general decline in health [34]; and CI may reflect a specific disease progression. In patients with AF, this latter hypothesis finds support in the pathogenetic links that have been formulated between AF and CI: shared risk factors (hypertension, diabetes, and congestive heart failure) [35]; beat-to-beat variability and reduced cardiac output, that may alter cerebral blood perfusion [9]; and hypercoagulable state, that may lead to the formation of thrombi in the left atrial appendage and ultimately to clinical and subclinical strokes [36]. In this regard, micro-infarcts, caused by microemboli originating in the heart, have been suspected to be a cause of brain atrophy and of lesions widely distributed on both sides of the brain [9,37] and therefore, eventually, of CI.…”
Section: Discussionmentioning
confidence: 99%