PB0177 - D-dimer Inversely Correlates with Neurocognitive Performance in Atrial Fibrillation: A 7-year Follow Up study

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Pratintip Lee, MD

Ph.D. candidate
Center for Molecular Cardiology, University of Zurich, Cantonal Hospital Baden, Switzerland
Baden Dättwil, Aargau, Switzerland

Co-Author(s)

SA

Stefanie Aeschbacher

Dr.
Cardiology, University Hospital Basel, University of Basel; Cardiovascular Research Institute Basel, University Hospital Basel
Basel, Basel-Stadt, Switzerland
MA

Meret Allemann

Ph.D. candidate
Center for Molecular Cardiology, University of Zurich, Cantonal Hospital Baden, Switzerland
Zurich, Zurich, Switzerland
MR

Martin Reiner

Dr. Med
Department of Cardiology, University Hospital Zurich
Zurich, Zurich, Switzerland
TZ

Thea Ziswisler

Dr.
Cantonal Hospital Baden, Switzerland
Baden, Aargau, Switzerland
RP

Rebecca Paladini

Dr.
Cardiology, University Hospital Basel, University of Basel; Cardiovascular Research Institute Basel, University Hospital Basel
Basel, Basel-Stadt, Switzerland
ML

Marco Luciani

Dr. Med
Department of Cardiology, University Hospital Zurich; Center for Translational and Experimental Cardiology, University Hospital Zurich
Zurich, Zurich, Switzerland
LB

Leo Bonati

Prof. Dr. Med
Department of Neurology and Stroke Center, University Hospital Basel;
Basel, Basel-Stadt, Switzerland
MK

Michael Kühne

Prof. Dr. Med
Cardiology, University Hospital Basel, University of Basel; Cardiovascular Research Institute Basel, University Hospital Basel
Zurich, Zurich, Switzerland
MH

Moalina Haller

Prof. Dr. Med
Institute of Primary Health Care (BIHAM), University of Bern; Department of General Internal Medicine, Inselspital, Bern University Hospital;
Bern, Bern, Switzerland
Tr

Tobias reichlin

Prof. Dr. Med
Department of Cardiology, Inselspital, Bern University Hospital
Bern, Bern, Switzerland
gm

giorgio moschovitis

Prof. Dr. Med
Division of Cardiology, Ente ospedaliero Cantonale (EOC), Istituto Cardiocentro Ticino, Ospedale Regionale di Lugano;
Lugano, Ticino, Switzerland
er

elia rigamonti

Prof. Dr. Med
Division of Cardiology, Ente ospedaliero Cantonale (EOC), Istituto Cardiocentro Ticino, Ospedale Regionale di Lugano;
Lugano, Ticino, Switzerland
as

annina stauber

Prof. Dr. Med
Department of Cardiology, Triemli Hospital Zurich
Zurich, Zurich, Switzerland
Am

Andreas mueller

Prof. Dr. Med
Department of Cardiology, Triemli Hospital Zurich
Zurich, Zurich, Switzerland
gc

giulio conte

Prof. Dr. Med
Division of Cardiology, Ente ospedaliero Cantonale (EOC), Istituto Cardiocentro Ticino, Ospedale Regionale di Lugano;
Lugano, Ticino, Switzerland
nr

nicolas rodondi

Prof. Dr. Med
Department of General Internal Medicine, Inselspital, Bern University Hospital; Department of Cardiology, Inselspital, Bern University Hospital;
Bern, Bern, Switzerland
dc

david conen

Prof. Dr.
Population Health Research Institute, McMaster University, Ontario, Canada
Ontario, Ontario, Canada
SO

Stefan Osswald

Prof. Dr. Med
Cardiology, University Hospital Basel, University of Basel; Cardiovascular Research Institute Basel, University Hospital Basel
Zurich, Zurich, Switzerland
JH

Jürg Hans Beer

Prof. Dr. Med
Center for Molecular Cardiology, University of Zurich, Cantonal Hospital Baden, Switzerland
Zurich, Zurich, Switzerland

Background: Atrial fibrillation (AF) is associated with cognitive impairment and dementia. D-dimer (DD) is a well-established marker of coagulation, while beta-thromboglobulin (BTG) is platelet activation marker. Their role as markers for cognitive function in AF is unknown.

Aims: We therefore aimed to determine the correlation between DD and BTG with cognitive function in AF patients.

Methods: This prospective Swiss-AF cohort included 2,275 patients. Plasma D-dimer and BTG were determined through standard ELISA and the Luminex Assay at baseline. We performed detailed neurocognitive assessments in patients at baseline and follow up period. Validated neurocognitive assessment tools included the global and specific assessments. We used mixed-effect linear regression models to determine association of DD and BTG over cognition. For conversion to cognitive impairment (defined as MoCA score < 26), we performed cox-proportional hazards regression model. Two adjustment models were applied as described in figure.

Results: Patients with AF (mean [SD] age, 73 [8.5]; 157 women [27%], mean [SD] follow-up, 3.6 [2.3] years) were assessed. We observed statistically significant negative associations of between D-dimer and neurocognitive assessments (table 1). Over time, we found that patients in the fifth quintile (highest) of DD are associated with increased risk of cognitive impairment with Hazards Ratio of 1.56 (95% CI 1.36-1.79, p< 0.001) in model 2, compared to patients in the first quintile (fig.1). The Kaplan-Meier survival curve (fig.2) demonstrated decreased probability of cognitive impairment-free patients in higher quintiles of DD. In sharp contrast, BTG exhibited no association at all with neurocognitive assessments at baseline. And over time, only the highest quintile of BTG increased risk of cognitive impairment (HR 1.17, 95%CI 1.04-1.31, p=0.007).

Conclusion(s): DD is negatively associated with cognitive performance in AF at baseline and over time. Our results suggest that plasma D-dimer levels may serve as a potential biomarker for cognitive impairment.