背景:心房颤动(AF)与认知障碍的风险增加有关。因此,探索可能与认知障碍相关的因素很重要。相应地,本研究旨在通过综合相关证据,系统评价房颤患者认知损害的相关因素。
方法:PubMed的数据库搜索,Embase,科克伦图书馆,WebofScience,CBM,CNKI,万方,和VIP数据库从成立到2023年12月21日进行。效应大小表示为组合比值比(OR)和95%置信区间(95%CI)。异质性通过Cochran的Q检验进行定性分析,并通过I2统计量进行量化。
结果:从8个数据库中确定了总共7,128项研究,纳入了3,491,423名参与者的39项研究。对19个影响因素进行Meta分析。高龄(OR=1.38,95%CI:1.11-1.71),女性(OR=2.19,95%CI:1.18-4.06),吸烟(OR=2.44,95%CI:1.24-4.80),高血压(OR=1.61,95%CI:1.27-2.03),糖尿病(OR=1.42,95%CI:1.20-1.67),听力障碍(OR=1.37,95%CI:1.05-1.81)是认知障碍的危险因素。高等教育水平(OR=0.57,95%CI:0.46-0.72),口服抗凝剂(OR=0.61,95%CI:0.48-0.78),新型口服抗凝剂(OR=0.63,95%CI:0.54-0.73),华法林(OR=0.55,95%CI:0.39-0.79),相对于华法林的新型口服抗凝剂(OR=0.88,95%CI:0.81-0.97),导管消融(OR=0.74,95%CI:0.58~0.94)和运动(OR=0.66,95%CI:0.61~0.72)是认知障碍的保护因素.
结论:年龄,性别,教育水平,吸烟,锻炼,高血压,糖尿病,听力障碍,抗凝治疗,和导管消融与房颤患者的认知功能障碍相关。
BACKGROUND: Atrial fibrillation (AF) is associated with an increased risk of cognitive impairment. Therefore, exploring factors which may be associated with cognitive impairment is important. Correspondingly, this study aimed to systematically evaluate factors associated with cognitive impairment in AF patients by synthesizing relevant evidence.
METHODS: A database search of the PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, Wanfang, and VIP databases was conducted from inception until December 21, 2023. The effect size was expressed as a combined odds ratio (OR) and 95 % confidence interval (95 % CI). The heterogeneity was qualitatively analyzed by Cochran\'s Q test and quantified by the I2 statistic.
RESULTS: A total of 7,128 studies were identified from the 8 databases, and 39 studies of 3,491,423 participants were included. A meta-analysis was performed on 19 influencing factors. Advanced age (OR=1.38, 95 % CI: 1.11-1.71), female sex (OR=2.19, 95 % CI: 1.18-4.06), smoking (OR=2.44, 95 % CI: 1.24-4.80), hypertension (OR=1.61, 95 % CI: 1.27-2.03), diabetes (OR=1.42, 95 % CI: 1.20-1.67), and hearing impairment (OR=1.37, 95 % CI: 1.05-1.81) were risk factors for cognitive impairment. A higher education level (OR=0.57, 95 % CI: 0.46-0.72), oral anticoagulants (OR=0.61, 95 % CI: 0.48-0.78), novel oral anticoagulants (OR=0.63, 95 % CI: 0.54-0.73), warfarin (OR=0.55, 95 % CI: 0.39-0.79), novel oral anticoagulants relative to warfarin (OR=0.88, 95 % CI: 0.81-0.97), catheter ablation (OR=0.74, 95 % CI: 0.58-0.94) and exercise (OR=0.66, 95 % CI: 0.61-0.72) were protective factors for cognitive impairment.
CONCLUSIONS: Age, sex, education level, smoking, exercise, hypertension, diabetes, hearing impairment, anticoagulation therapy, and catheter ablation were associated with cognitive impairment in AF patients.