Evidence map›Paper›PMID 41593217›Full record

ArticleCommunications medicine2026

Ischemic brain infarcts, white matter hyperintensities, and cognitive impairment are increased in patients with Atrial Fibrillation.

Philipp Krisai, Stefanie Aeschbacher, Michael Coslovsky, Nikki Rommers, Tobias Reichlin, Andreas S Müller, Jürg H Beer, Peter Ammann, Angelo Auricchio, Giorgio Moschovitis and 22 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02105844 (Swiss Atrial Fibrillation Cohort Study - SWISS AF), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02105844 active not recruitingnot on this map

Swiss Atrial Fibrillation Cohort Study - SWISS AF

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2014 to 2030Enrolled2,415ConditionsAtrial Fibrillation
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Philipp KrisaiCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland. philipp.krisai@usb.ch.ORCID http://orcid.org/0000-0002-4367-2363
Stefanie AeschbacherCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
Michael CoslovskyCardiovascular Research Institute Basel, University Hospital Basel, University Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0001-7678-7354
Nikki RommersDepartment of Clinical Research, University Basel, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-0311-5009
Tobias ReichlinDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas S MüllerDepartment of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland.ORCID http://orcid.org/0000-0001-7845-9012
Jürg H BeerDepartment of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Zürich, Switzerland.ORCID http://orcid.org/0000-0002-7199-0406
Peter AmmannDepartment of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Angelo AuricchioDivision of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland.
Giorgio MoschovitisDivision of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland.ORCID http://orcid.org/0000-0002-4043-8061
Richard KobzaDepartment of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland.
Dipen ShahDivision of Cardiology, Department of Medical Specialities, University Hospital Geneva, Geneva, Switzerland.
Marcello Di ValentinoDivision of Cardiology, Ospedale San Giovanni, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Giulio ConteDivision of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland.
Georg EhretDivision of Cardiology, Department of Medical Specialities, University Hospital Geneva, Geneva, Switzerland.
Elisa HenningsCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-2616-5535
Andreas MonschMemory Clinic, Universitäre Altersmedizin, Felix Platter Spital Basel, University of Basel, Basel, Switzerland.
Rebecca E PaladiniCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Laurent RotenDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-0827-1329
Matthias SchwenkglenksEpidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zürich, Switzerland.ORCID http://orcid.org/0000-0001-7217-1173
Christian SticherlingCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0001-8428-7050
Patrick BadertscherCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
Christine S ZuernCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
Tim SinneckerDepartment of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland.
Marco DueringMedical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
Felix MahfoudCardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-4425-549X
Leo H BonatiDepartment of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-1163-8133
David ConenPopulation Health Research Institute, McMaster University, Hamilton, Canada.
Stefan Osswald *Cardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
Michael Kühne *Cardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
eMBA, for the Swiss-AF Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe interrelationships between atrial fibrillation (AF), brain lesions and cognitive function are poorly understood. We aimed to investigate the relationship of AF with brain lesions and cognition.

methodsWe enrolled 1,480 patients with and 959 without AF in a multicenter prospective study (Swiss-AF; NCT02105844). We assessed brain structure, and cognition using the Montreal Cognitive Assessment (MoCA). Brain magnetic resonance imaging (MRI) was performed to assess large non-cortical and cortical infarcts (LNCCI), small non-cortical infarcts (SNCI), white matter hyperintensities (WMH), and microbleeds. Using causal mediation analyses, we investigated the direct (lesion-independent) and indirect (lesion-mediated) effects of AF on cognition.

resultsMean age in AF patients is 75.0 vs. 74.2 years in no-AF patients, 28.6% vs. 36.9% are female, and comorbidities are comparable. The prevalence of MRI-detected brain infarcts (LNCCI and/or SNCI) is 40.1% in AF patients vs. 24.0% in no-AF patients, adjusted OR (95% CI): 1.78 (1.30; 2.44), p = 0.0003. WMH (Fazekas ≥2) are more prevalent in AF patients (59.2% vs 44.4%), adjusted OR (95% CI): 2.03 (1.50; 2.77), p = 4.6e-06. The mean MoCA score is 25.3 in AF patients and 26.4 in no-AF patients. In mediation analysis, the total effect of AF on cognition is -1.05 MoCA points, decomposed into a direct effect of -0.99 and an indirect, lesion-mediated, effect of -0.06 points.

conclusionsThe prevalence of ischemic brain infarcts and WMH is higher in patients with AF than without AF despite comparable comorbidities. AF is associated with lower cognitive function, primarily through a direct effect rather than mediated by brain lesions.

Identifiers

PMID41593217
PMCPMC12916941

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Registered trials

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