Table 4:
Multivariable association between atrial fibrillation (at baseline or follow up) and cognitive and functional outcomes in subgroups of patients defined by occurrence of stroke (previous history or during follow-up) by recruitment, ethnicity or treatment with ACE inhibitors or angiotensin receptor blockers
| Subgroup | Decrease in MMSE score ≥ 3, HR (95% CI) | Dementia during follow-up, HR (95% CI) | Loss of independence in ADL, HR (95% CI) | Admission to long-term care, HR (95% CI) | Composite outcome* | |
|---|---|---|---|---|---|---|
| HR (95% CI) | p value† | |||||
| Overall | 1.14 (1.03–1.26) | 1.32 (1.15–1.51) | 1.37 (1.20–1.56) | 1.55 (1.33–1.81) | 1.21 (1.13–1.30) | |
| Stroke at follow-up | 1.08 (0.79–1.48) | 1.13 (0.78–1.63) | 1.25 (0.94–1.67) | 1.13 (0.80–1.59) | 1.14 (0.92–1.40) | |
| No stroke at follow-up | 1.12 (1.01–1.25) | 1.28 (1.10–1.48) | 1.29 (1.12–1.49) | 1.49 (1.25–1.77) | 1.18 (1.09–1.28) | 0.2 |
| Stroke at follow-up or baseline | 1.25 (1.06–1.47) | 1.39 (1.13–1.71) | 1.42 (1.17–1.71) | 1.33 (1.04–1.69) | 1.18 (1.05–1.33) | |
| No stroke | 1.06 (0.93–1.20) | 1.21 (1.01–1.44) | 1.26 (1.05–1.50) | 1.63 (1.34–2.00) | 1.21 (1.10–1.33) | 0.47 |
| ONTARGET participant | 1.16 (1.04–1.29) | 1.39 (1.19–1.61) | 1.38 (1.20–1.59) | 1.58 (1.34–1.87) | 1.25 (1.15–1.35) | |
| TRANSCEND participant | 1.07 (0.84–1.36) | 1.07 (0.78–1.47) | 1.32 (0.96–1.82) | 1.27 (0.84–1.93) | 1.07 (0.89–1.27) | 0.2 |
| European | 1.11 (0.99–1.24) | 1.21 (1.03–1.41) | 1.44 (1.25–1.66) | 1.43 (1.21–1.69) | 1.20 (1.11–1.31) | |
| Non-European | 1.29 (1.04–1.59) | 1.74 (1.32–2.29) | 1.05 (0.76–1.45) | 1.56 (0.96–2.52) | 1.22 (1.04–1.42) | 0.4 |
| No ACE inhibitors or angiotensin receptor blockers | 1.41 (0.69–2.85) | 1.22 (0.47–3.17) | 2.09 (0.96–4.55) | 2.47 (0.80–7.64) | 1.76 (1.08–2.88) | |
| ACE inhibitors only | 1.09 (0.90–1.31) | 1.29 (0.99–1.67) | 1.34 (1.06–1.70) | 1.56 (1.17–2.09) | 1.20 (1.05–1.37) | |
| Angiotensin receptor blockers only | 1.03 (0.80–1.33) | 1.51 (1.07–2.14) | 1.41 (0.99–1.99) | 1.28 (0.83–1.97) | 1.25 (1.03–1.51) | |
| ACE inhibitors and angiotensin receptor blockers | 1.20 (1.05–1.37) | 1.31 (1.09–1.58) | 1.37 (1.15–1.63) | 1.58 (1.28–1.94) | 1.20 (1.08–1.32) | 0.49 |
Note: ACE = angiotensin-converting enzyme, ADL = activities of daily living, CI = confidence interval, HR = hazard ratio
*
Decrease in MMSE score of 3 points or more, new diagnosis of dementia at follow-up, loss of independence with performing ADL and admission to a long-term care facilty.
†
Wald test for interaction between subgroups and atrial fibrillation.