Special Issue "Treatment of Stroke, Dementia and Atrial Fibrillation"

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: 10 January 2022.

Special Issue Editors

Prof. Dr. Vincenzo Russo
E-Mail Website
Guest Editor
Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli” – Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
Interests: atrial fibrillation; cardiovascular pharmacology; arrhythmic disorders; cardiac pacing; non-vitamin K oral anticoagulants; neuromuscular disorders; muscular dystrophies
Special Issues and Collections in MDPI journals
Dr. Riccardo Proietti
E-Mail Website
Guest Editor
Department of Cardiac, Thoracic, and Vascular Sciences – University of Padua, Via Giustiniani 2, 35121 Padua, Italy
Interests: stroke; cerebrovascular events; silent stroke; dementia; mild cognitive impairment; anticoagulation; non vitamin k oral anticoagulants; atrial fibrillation; cardiac pacing

Special Issue Information

Dear Colleagues,

Stroke and dementia are among the top ten causes of death worldwide as estimated by the World Health Organization. Atrial fibrillation (AF) is estimated to cause of about 15 percent of all ischemic strokes and as many as 30 percent of strokes occurring in people in their 80s. The reduction of burden of stroke related to AF is a difficult goal to achieve because of a few clinical characteristics of AF itself: 1) episodes of arrhythmias may be asymptomatic and misdiagnosed, 2) stroke related to AF tends to be recurrent if an appropriate treatment is not promptly initiated, 3) the occurrence during AF of silent ischemic stroke that may not clinically manifest but may impact cognitive function. Indeed, silent ischemic cerebrovascular events have been recently proposed as the main pathophysiologic mechanisms linking AF with cognitive decline and dementia. 4) Finally, in AF the disjunction between the risks of cerebrovascular events (CVE) and the burden of arrhythmias is held as a dominant concept. Accordingly, the risk of CVE is not directly related to the presence of the arrhythmia but persists even during arrhythmia-free intervals. In other words, the two forms of AF classified according to duration (paroxysmal vs persistent) of arrhythmias hold the same risk of stroke.

Given the complexity of this topic and its impact on clinical practice and public health, Medicina is launching a Special Issue entitled “Stroke, Dementia and Atrial Fibrillation” with the aim of gathering together accurate and up-to-date scientific information on all aspects of association between cerebrovascular events, cognitive impairment and AF. We are pleased to invite you and your co-workers to submit your original research articles reporting on the pathophysiological mechanisms underpinning this association. We also encourage the submission of original manuscripts spanning basic to clinical research and focusing on stroke prevention in AF. We would also like to invite you to submit review articles aimed at providing a comprehensive overview of the recent advances in understanding pharmacological interventions to prevent CVE.

Prof. Dr. Vincenzo Russo
Prof. Dr. Riccardo Proietti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Atrial Fibrillation
  • Stroke
  • Cognitive Impairment
  • Dementia
  • Oral anticoagulation
  • Non vitamin K oral anticoagulants
  • Cardiac implanted devices
  • Cardiomyopahty
  • Neuromuscular Disorders

Published Papers (1 paper)

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Research

Article
Cognition, Statins, and Cholesterol in Elderly Ischemic Stroke Patients: A Neurologist’s Perspective
Medicina 2021, 57(6), 616; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060616 - 13 Jun 2021
Viewed by 419
Abstract
Background and Objectives: The efficacy of hydroxy methyl glutaryl-coenzyme A reductase inhibitors (statins) in reducing the incidence of cardiovascular events pushed the target LDL-cholesterol (LDL-C) levels lower and lower in successive guidelines despite signals regarding potential cognitive side effects. We evaluated the relationship [...] Read more.
Background and Objectives: The efficacy of hydroxy methyl glutaryl-coenzyme A reductase inhibitors (statins) in reducing the incidence of cardiovascular events pushed the target LDL-cholesterol (LDL-C) levels lower and lower in successive guidelines despite signals regarding potential cognitive side effects. We evaluated the relationship between cognitive impairment and LDL-C levels in elderly ischemic stroke patients. Materials and Methods: 29 ischemic stroke patients aged 65 and above with LDL-C levels ≤70 mg/dL, classified according to the TOAST criteria, underwent detailed neuropsychological testing comprising the MMSE test, Montreal Cognitive Assessment (MoCA) and Addenbrooke’s Cognitive Evaluation (ACE-III) test. Their performances were compared to those of 29 age-matched ischemic stroke patients with LDL-Cl levels >71 mg/dL. Results: The MMSE test failed to detect significant cognitive differences between the two groups. The MoCA and ACE-III tests detected impairments in visuo-spatial/executive function, attention, and recall/memory in patients with low LDL-C. A stepwise linear regression model of the ACE-III total scores revealed that LDL-cholesterol levels could contribute to 13.8% of the detected cognitive dysfunction, second in importance only to age, which contributed to 38.8% of the detected impairment. Conclusions: Physicians should be cautious when prescribing statins to elderly people. Hydrophilic ones may be preferred in cognitively impaired patients. Full article
(This article belongs to the Special Issue Treatment of Stroke, Dementia and Atrial Fibrillation)
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