Cognitive function in patients with non valvular atrial fibrillation: correlation to markers of thrombogenesis

There is increasing evidence that non valvular atrial fibrillation NVAF is associated with an increased risk of asymptomatic or silent cerebral infarctions. An important question is whether these infarction are truly asymptomatic and whether anti-thrombotic treatment could be beneficial in those patients. In this study we examined components of cognitive function [Event Related Potentials "ERP[s]" P300 and Wechsler Adult Intelligence Scale "WAIS"] and markers of thrombogenesis [fibrinogen, fibrinopeptide A "FPA". platelet aggregation, platelet factor 4 "PF-4" and beta-thromboglobulin "beta T.G"] in 20 neurologically asymptomatic NVAF patients comparing them to a well matched group in sinus rhythm. In addition, parameters of cognitive function components were correlated to those of thrombogenesis in the group of AF patients. NVAF patients had significantly prolonged latency and significantly reduced amplitude of P300 component of ERPs in AF Vs sinus rhythm group respectively and significantly reduced verbal intelligence quotient [VIQ] component of [WAIS] Vs sinus rhythm group P< 0.006. In addition, NVAF patients had significantly elevated levels of fibrinogen [p< 0.01], FPA [p<0.001], significant platelet aggregation is response to 2 ug/ml collagen [p< 0.001] and 1 ug/ml collagen [P< 0.001] and significantly elevated levels of PF-4 [P< 0.01] and beta T. G [P< 0.001] compared to the group in sinus rhythm respectively. In the NVAF group, there was positive association between P300 latency of ERPs components and each of FPA and PF-4 with high P< 0.1 and marginal P= 0.05 significance respectively and significant inverse correlation between all parameters of WAIS components and those of thrombogenesis except for the relation of performance intelligence quotient [PIQ] to each of FPA and beta T.G levels. These results may aid in identifying those patients at high risk of developing dementia and may help decision making when anti thrombotic therapy is being considered in NVAF patients. We recommend cognitive

Blood pressure variability in acute cerebral infraction and hemorrhage

This study included 115 patients with acute cerebrovascular stroke [63 patients with thromboembolic infraction, 28 patients with lacunar infarction and 24 patients with intracerebral hemorrhage] as well as 49 age and sex matched patients with other than acute cerebrovascular stroke were taken as a control group. There was a significant transient elevation of both mean systolic [SBP] and diastolic blood pressure [DBF] in the first day of admission in the various subtypes of stroke patients compared with the seventh day. The initial elevation of blood pressure was not due to stress of hospitalization because it was not present in the control group. There was a significant positive correlation between the elevation of systolic blood pressure and diastolic blood pressure in the first day in both thromboembolic and lacunar subtype. It was concluded that there was a spontaneous decline in both systolic and diastolic blood pressure after acute stroke; so, the use of antihypertensive drugs must be carefully judged in those patients