Association of cognitive impairment with dyslipidemia in patients with atrial fibrillation: preliminary results from a prospective registry
S Mohanty, A Mayedo, B Macdonald, V M La Fazia, C A R O L A Gianni, M Marino, E Chiarazzo, A Al-Ahmad, J D Burkhardt, P G Torlapati, G J Gallinghouse, R Horton, K Awad, L Di Biase, A N D R E A NataleAbstract
Background
Dyslipidemia is known to be associated with an increased risk of cognitive impairment (CI). Studies have shown 1.23-fold higher risk of CI in patients with dyslipidemia vs without.
Objective
We investigated cognitive function in dyslipidemia patients treated with statin drugs vs those with normal lipid profile.
Methods
In this prospective study, consecutive patients attending our arrhythmia clinics for atrial fibrillation (AF) that were willing to undergo Montreal Cognitive Assessment (MoCA) at baseline and 1-year follow-up were enrolled in the DIAL-AF registry. In the MoCA survey, with a scale of 0-30, 27-30 is considered normal cognition, 18-26 as mild cognitive impairment (MCI) and ≤ 17 as dementia. Patients with baseline score of ≤17 were excluded from the analysis. DIAL-AF registry patients with dyslipidemia-on statin (DL group) were propensity matched 1:2 with those without dyslipidemia (non-DL group).
Results
A total of 125 patients from the DIAL-AF registry were included in the DL group and propensity-matched with 250 patients from the same registry without dyslipidemia (non-DL group). Clinical characteristics of the study population is provided in table 1.
Baseline MoCA score was 26.03 ±2.41 in the DL-group vs 26.07±2.11 in the non-DL group (p=NS). At 1-year follow-up, mean MoCA score was significantly lower from the baseline score in the DL group (25.05±2.93, p<0.001) and higher (27.11±2.02, p<0.001) in the non-DL group (figure 1). Mean change in the score was -0.98±2.71 and 1.04±2.07 in the DL and non-DL group respectively (p<0.001).
In the multivariable regression analysis, dyslipidemia on statin therapy was found to be a predictor of cognitive decline (Odd’s Ratio = 1.471; 95% CI 1.101 – 2.814; P-value = 0.027).
Conclusion
In AF patients with dyslipidemia, significant cognitive decline was evident despite being on statin therapy, whereas the MoCA score improved in the non-DL group.