Risk of cerebrovascular pathologies in elderly people with atrial fibrillation

Takeaway

  • At age 70 years, people with atrial fibrillation (AF) had greater odds of several cerebrovascular pathologies, including symptomatic stroke and magnetic resonance imaging (MRI)-based findings of large infarcts, lacunes, and silent brain infarcts, compared to people without AF.

Why this matters

  • AF is a common clinical finding, affecting 1–4% of adults and >13% of people aged over 80 years. AF has been associated with increased risk of symptomatic stroke, dementia, and mortality; however, the mechanism linking AF with these complications is unclear.

  • Cerebral small vessel disease (cSVD) is an important consideration when assessing AF and risk of cerebrovascular pathology. It is currently unknown whether AF is linked not only to symptomatic stroke, but to silent infarcts and indicators of cSVD including cerebral microbleeds, white matter hyperintensities, and lacunes.