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Volume 13
Issue 4
10.3390/biomedicines13040941
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Article

Markers of Inflammation and Hypofibrinolysis Are Associated with Cognitive Dysfunction and Motor Performances in Atrial Fibrillation Patients on Oral Anticoagulant Therapy: Insights from the Strat-AF Study

by
Francesco Alfano
1,2,*,
Francesca Cesari
1,2,
Anna Maria Gori
1,2,
Martina Berteotti
1,2,
Emilia Salvadori
3,
Betti Giusti
1,2,
Alessia Bertelli
1,2,
Filippo Fratini
4,
Angela Rogolino
1,2,
Benedetta Formelli
4,5,
Francesca Pescini
4,5,
Enrico Fainardi
6,
Eleonora Barucci
4,
Giulia Salti
5,
Arianna Cavaliere
4,
Andrea Ginestroni
6,
Rossella Marcucci
1,2,† and
Anna Poggesi
4,5,†
1
Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
2
Center for Atherothrombotic Diseases, Careggi University Hospital, 50134 Florence, Italy
3
Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
4
NEUROFARBA Department, Neuroscience Section, University of Florence, 50134 Florence, Italy
5
Stroke Unit, Careggi University Hospital, 50134 Florence, Italy
6
Neuroradiology Unit, Careggi University Hospital, Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2025, 13(4), 941; https://doi.org/10.3390/biomedicines13040941
Submission received: 5 February 2025 / Revised: 20 March 2025 / Accepted: 10 April 2025 / Published: 11 April 2025
(This article belongs to the Special Issue Molecular and Cellular Mechanisms of CVD: Focus on Atherosclerosis (Volume II))
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Abstract

Background: Atrial fibrillation (AF) is the most common supraventricular arrythmia and one of the most commonly encountered heart conditions in clinical practice. Emerging evidence suggests a significant role of inflammation in the pathogenesis of AF. Population studies have also suggested an association between AF and cognitive impairment and dementia. The aim of this study is therefore to assess, in a population of AF patients on oral anticoagulant therapy, the association between circulating biomarkers involved in the pathogenesis of AF and the cognitive and motor performances of the enrolled patients. Methods: The Strat-AF study is an observational, prospective, single-center, hospital-based study enrolling elderly patients with AF. Results refer to 180 subjects who underwent a complete clinical, biohumoral, cognitive, and functional evaluation. Results: At multivariate logistic regression, Clot Lysis Time (CLT) and circulating levels of von Willebrand Factor (vWF) remained significantly associated with pathological performances at the Stroop test (expressed as execution time) [OR 95% CI 1.54 (1.02–2.35), p = 0.042 and 1.75 (1.08–2.82), p = 0.023, respectively]. With regard to the Short Physical Performance Battery (SPPB), the circulating levels of IL-8 remained significantly associated with the clinical endpoint [OR 95% CI 2.19 (1.13–4.25), p = 0.020]. Conclusions: Our results suggest a potential innovative tool able to identify AF patients at risk of worse prognosis in terms of cognitive and motor performances. The clinical relevance of these results is due to the fact that we have no efficient methods to predict a deterioration in the cognitive performance and, consequently, the possible onset of dementia in AF patients undergoing oral anticoagulant therapy.
Keywords: atrial fibrillation; oral anticoagulant therapy; biomarkers; inflammation; hypofibrinolysis; cognitive performance; motor performance atrial fibrillation; oral anticoagulant therapy; biomarkers; inflammation; hypofibrinolysis; cognitive performance; motor performance
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MDPI and ACS Style

Alfano, F.; Cesari, F.; Gori, A.M.; Berteotti, M.; Salvadori, E.; Giusti, B.; Bertelli, A.; Fratini, F.; Rogolino, A.; Formelli, B.; et al. Markers of Inflammation and Hypofibrinolysis Are Associated with Cognitive Dysfunction and Motor Performances in Atrial Fibrillation Patients on Oral Anticoagulant Therapy: Insights from the Strat-AF Study. Biomedicines 2025, 13, 941. https://doi.org/10.3390/biomedicines13040941

AMA Style

Alfano F, Cesari F, Gori AM, Berteotti M, Salvadori E, Giusti B, Bertelli A, Fratini F, Rogolino A, Formelli B, et al. Markers of Inflammation and Hypofibrinolysis Are Associated with Cognitive Dysfunction and Motor Performances in Atrial Fibrillation Patients on Oral Anticoagulant Therapy: Insights from the Strat-AF Study. Biomedicines. 2025; 13(4):941. https://doi.org/10.3390/biomedicines13040941

Chicago/Turabian Style

Alfano, Francesco, Francesca Cesari, Anna Maria Gori, Martina Berteotti, Emilia Salvadori, Betti Giusti, Alessia Bertelli, Filippo Fratini, Angela Rogolino, Benedetta Formelli, and et al. 2025. "Markers of Inflammation and Hypofibrinolysis Are Associated with Cognitive Dysfunction and Motor Performances in Atrial Fibrillation Patients on Oral Anticoagulant Therapy: Insights from the Strat-AF Study" Biomedicines 13, no. 4: 941. https://doi.org/10.3390/biomedicines13040941

APA Style

Alfano, F., Cesari, F., Gori, A. M., Berteotti, M., Salvadori, E., Giusti, B., Bertelli, A., Fratini, F., Rogolino, A., Formelli, B., Pescini, F., Fainardi, E., Barucci, E., Salti, G., Cavaliere, A., Ginestroni, A., Marcucci, R., & Poggesi, A. (2025). Markers of Inflammation and Hypofibrinolysis Are Associated with Cognitive Dysfunction and Motor Performances in Atrial Fibrillation Patients on Oral Anticoagulant Therapy: Insights from the Strat-AF Study. Biomedicines, 13(4), 941. https://doi.org/10.3390/biomedicines13040941

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