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Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy
Knecht S, Oelschläger C, Duning T, Lohmann H, Albers J, Stehling C, Heindel W, Breithardt G et al.. European heart journal, 2008-07-29
Topic: Amyloid, tau and blood-test diagnosis
Aims To determine whether atrial fibrillation (AF) in stroke-free patients is associated with impaired cognition and structural abnormalities of the brain. AF contributes to stroke and secondary cognitive decline. In the absence of manifest stroke, AF can activate coagulation and cause cerebral microembolism which could damage the brain. Methods and results We cross-sectionally evaluated 122 stroke-free individuals with AF recruited locally within the German Competence Network on AF. As comparator, we recruited 563 individuals aged 37-84 years without AF from the same community. Subjects underwent 3 T magnetic resonance imaging to assess covert territorial brain infarction, white matter lesions, and brain volume measures. Subjects with evidence for stroke, dementia, or depression were excluded. Cognitive function was assessed by an extensive neuropsychological test battery covering the domains learning and memory, attention and executive functions, working memory, and visuospatial skills. Cognitive scores and radiographic measures were compared across individuals with and without AF by stepwise multiple regression models. Stroke-free individuals with AF performed significantly worse in tasks of learning and memory (ß = -0.115, P Conclusion Even in the absence of manifest stroke, AF is a risk factor for cognitive impairment and hippocampal atrophy. Therefore, cognition and measures of structural brain integrity should be considered in the evaluation of novel treatments for AF.
Key findings
- Aims To determine whether atrial fibrillation (AF) in stroke-free patients is associated with impaired cognition and structural abnormalities of the brain.
- Methods and results We cross-sectionally evaluated 122 stroke-free individuals with AF recruited locally within the German Competence Network on AF.
- Stroke-free individuals with AF performed significantly worse in tasks of learning and memory (ß = -0.115, P Conclusion Even in the absence of manifest stroke, AF is a risk factor for cognitive impairment and hippocampal atrophy.
Why it matters
In this cross-sectional study, stroke-free people with atrial fibrillation performed worse on learning and memory tasks and had hippocampal atrophy compared with people without atrial fibrillation. This identifies atrial fibrillation as a risk factor for cognitive impairment even without stroke, but does not test whether treating it prevents dementia.
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Study details
- Participants563
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (European heart journal) |
| Journal's citation record | 3 / 4 | European Heart Journal: journal h-index 456 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 563 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 360 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.0 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 4 / 6 | Cited 9.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 2 / 4 | Cited 44 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Heike Wersching: h-index 33 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Münster: institution h-index 833 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18667399) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 50 / 100 | — |
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Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Knecht, S., Oelschläger, C., Duning, T., Lohmann, H., Albers, J., Stehling, C., et al. (2008). Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. European heart journal. https://doi.org/10.1093/eurheartj/ehn341
Vancouver
Knecht S, Oelschläger C, Duning T, Lohmann H, Albers J, Stehling C, et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. European heart journal. 2008. doi:10.1093/eurheartj/ehn341. PMID: 18667399.
BibTeX
@article{knecht2008-18667399,
author = {Knecht, S. and Oelschläger, C. and Duning, T. and Lohmann, H. and Albers, J. and Stehling, C. and Heindel, W. and Breithardt, G. and others},
title = {{Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy}},
journal = {European heart journal},
year = {2008},
doi = {10.1093/eurheartj/ehn341},
pmid = {18667399},
url = {https://doi.org/10.1093/eurheartj/ehn341}
}
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