PS 15-26 COGNITIVE FUNCTION IN PATIENTS WITH NON VALVULAR ATRIAL FIBRILLATION: CORRELATION TO MARKERS OF THROMBOGENISIS

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Abstract

Objective:

There is increasing evidence that non valvular atrial fibrillation (NVAF) is associated with an increased risk of silent cerebral infarctions .An important question is whether these infarctions are truly asymptomatic .The aim of this work is to examine cognitive function components and markers of thrombogenisis in neurologically asymptomatic patients with (NVAF).

Design and Method:

Twenty neurologically asymptomatic NVAF patients and 20 none AF individuals were compared. Control subjects were in sinus rhythm and patient's matched regarding age, sex, level of education and the underlying medical disorders. Full medical history and clinical examination, ECHO, neuropsychological examination using Mini Mental state as a screening test,Wechsler Adult Intelligence Scale (WAIS), {including digit span for measuring short term verbal memory and attention and digit symbol for psychomotor performance} and Event-related potentials ERPs, in addition to laboratory parameters including fibrinogen level,fibrinopeptide A (FPA), platelets aggregation in response to 2 and 1ug/ml collagen,platelet factor 4 (PF-4) and B-thromboglobulin (BTG) were done to all the studied populations.

Results:

NVAF patients had significantly prolonged latency, significantly reduced amplitude of P300 component of (ERPs) and significantly reduced verbal intelligence quotient component of (WAIS) Vs sinus rhythm persons. NVAF patients have significant elevation of fibrinogen, (FPA), (PF -4) and (B T.G) level sand significant platelet aggregation in response to 2ug/ml collagen and 1 ug /ml collagen Vs sinus rhythm population .Positive association between (P300) latency of (ERPS) components and each of (EPA) and (PF-4) and significant inverse correlation between all parameters of (WAIS) components and those of thrombogenisis were detected in patient with NVAF.

Conclusions:

Cognitive functions impairment in patients with NVAF is a warning sign for the future development of thromboembolism. Evaluation of these functions in asymptomatic patients with NVAF is recommended.

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