Atrial Fibrillation and Dementia. Blood thinners may prevent cognitive dysfunction

By: Dr. Sunil Kadakia, MD, FACC, FSCAI, CPE and

Dr. Irina Staicu, MD, FACC ,RVPI ABVLM Diplomat,  
ADVOCATE HEART INSTITUTE AT GOOD SHEPHERD HOSPITAL

WHY ATRIAL FIBRILLATION CAN BE A DEADLY DISEASE 

Atrial Fibrillation:

  • Greatly increases the risk for stroke
  • Accounts for up to 15% of strokes in persons of all ages, and up to 30% in those over age 80 (Patel et al, 2011)
  • Over 2 million people in the US are currently in atrial fibrillation with incidence projected to rise above 5.6 million by 2050 (Gladstone et al, 2009)
  • Ischemic strokes resulting from cardio-embolism tend to be more severe with a one-year mortality rate estimated at 50% (Gladstone et al, 2009)
  • Causes Tachycardia Cardiomyopathy, Limb Ischemia, Bowel Ischemia and Gangrene of Toes/Fingers

New in 2018 guidelines Preventive measures of cognitive dysfunction in patients with atrial fibrillation

Appropriate anticoagulation in patients with AF and stroke risk factors should be applied for the prevention of cognitive dysfunction.

Consider a non-vitamin K antagonist oral anticoagulant (NOAC) instead of vitamin K antagonist (VKA) when using oral anticoagulation for the prevention of stroke in AF, which may have a beneficial effect on subsequent cognitive disorders.

https://reference.medscape.com/viewarticle/898528_2

Updated AF guidelines recommend newer oral anticoagulants for stroke -2018!

Non vitamin K oral anticoagulants are now recommended over warfarin to reduce the risk for stroke in patients with atrial fibrillation, excluding those with moderate to severe mitral stenosis or a mechanical heart valve, (American Heart Association, American College of Cardiology and Heart Rhythm Society. 2018)

http://www.advocatecq.com/issues/2/articles/18

Dr. Sunil Kadakia is a Board Certified physician in Internal Medicine, General Cardiology and Interventional Cardiology. He is Chairman of the hospital’s Cardiology Section, the Medical Director for Cardiovascular Services and Cath Lab at Advocate Good Shepherd and is a Certified Physician Executive.

Dr. Irina Staicu is the founder and Director of the Vascular and Vein program affiliated with the hospital. She is a Board Certified physician in Internal Medicine, Invasive Cardiology and Nuclear Cardiology. She is one of the first physicians to achieve Diplomat status in Venous and Lymphatic Medicine and is also a certified physician for vascular interpretation, giving her the comprehensive knowledge of the diagnostic technologies required for the most advanced vascular and vein diagnoses. 

Dr. Kadakia and Dr. Staicu have extensive expertise in the safe, effective and patient-centered treatment of all types of cardiovascular disease. They are committed partners with their patients and provide personalized care for each one.

http://www.advocatecq.com/issues/2/articles/18

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