AF is also a well-established risk factor for dementia. For example, Liao et al reported a consistently higher rate of cognitive decline and risk of dementia in patients with AF. 11 These associations are partly due to the increased risk of clinical stroke in AF, but other mechanisms are likely to contribute, including the occurrence of SCI and microbleeds. 12 Current evidence is not sufficient to support a trend of increased prevalence of dementia in East Asia over the last few decades, but AF may contribute to dementia risk. We conducted a meta-analysis to compare the association of AF and SCI between East Asian and non-Asian patients.
Methods
Data SourcesPubMed were searched from their inception to 7 October 2017. No language restriction was applied. To ensure a comprehensive search of the literature, we also manually A trial fibrillation (AF) is the most common cardiac arrhythmia 1 and a major cause of stroke. The estimated global prevalence of AF is approximately 1-2%. 2 In Asia, the prevalence of AF has been reported to be slightly lower than that in Western populations. 3,4 Due to the much larger population in Asia, the burden of AF is estimated to be much greater in Asian than in Western populations. Indeed, it has been estimated that in 2050 there will be 72 million patients with AF in Asia, 4 more than double the combined number of patients from Europe and the USA. 1,5 Therefore, it is particularly important that AF is effectively managed in the ageing population of Asia.Silent cerebral infarction (SCI) is defined as the presence of cerebral infarction with the absence of corresponding clinical symptoms. In a recent meta-analysis, AF was associated with a more than 2-fold increased risk for SCI. 6 Several studies have reported an association between AF and increased risk of SCI in East Asian countries, 7-10 with the presence of SCI predicting subsequent clinically overt stroke. Thus, the prevalence of SCI and its effect as a risk factor for overt stroke are important considerations during the evaluation of AF.