Anemia effect on cognitive function in patients with coronary artery disease and atrial fibrillation receiving dual antithrombotic therapy
Bibliographic record
Abstract
Background: the coexistence of atrial fibrillation (AF) and coronary artery disease (CAD) is associated not only with an increased risk of thromboembolic events, but also with the development of cognitive impairment (CI) and dementia. Administration of dual antithrombotic therapy (DAT) in this cohort is accompanied by an elevated risk of bleeding and, consequently, anemia. In turn, anemia itself is closely linked to the progression of CI and the development of dementia, both of which are associated with a worsened prognosis. Aim: to analyze the impact of anemia on cognitive function in patients with concomitant AF and CAD who are receiving DAT Materials and Methods: a prospective open cohort study enrolled 126 patients (mean age 69.5 [63;76] years; 62.7% male) with AF and CAD receiving DAT. Participants were divided into two groups: group 1 included patients with anemia (n=27), while group 2 consisted of patients without anemia (n=99). All patients underwent cognitive assessment using the Montreal Cognitive Assessment (MoCA), the MiniMental State Examination (MMSE), the Trail Making Test (parts A and B), verbal association tests (literal and categorical), the 10word recall test, and the Stroop test. Depression and anxiety levels were also evaluated using the Hamilton and Beck scales. Results: comparison of MoCA scores revealed that the median total score in group 1 was significantly lower than in group 2 (24.5 [23;26] vs. 25.5 [24;27] points, p=0.048). Analysis of MMSE results yielded similar findings: a statistically higher proportion of group 2 patients achieved scores within the normal range (15.2%), whereas no such patients were observed in group 1 (p=0.039). Completion time for part B of the Trail Making Test was significantly longer in group 1 versus group 2 (210.0 [169.0; 333.0] vs. 163.0 [126.3; 236.0] seconds, p=0.024). Conversely, patients in group 1 produced significantly more words in both the literal (9 [7; 11] vs. 7 [4; 10]) and categorical association subtests (15 [12; 18] vs. 13 [10; 15]) than those in group 2 (p=0.022 and p=0.026, respectively). In the 10word immediate recall test, group 1 patients recalled significantly fewer words than those in group 2 (3 [2; 4] vs. 4 [3; 5] words, p=0.009); however, no statistically significant differences were observed in delayed recall. Conclusion: anemia in patients with concomitant AF and CAD is associated with more pronounced cognitive impairment. Early detection and treatment of anemia in such patients may contribute to reducing the risk of CI and dementia, thereby improving their quality of life. KEYWORDS: atrial fibrillation, anemia, coronary artery disease, cognitive impairment, dementia, direct oral anticoagulants, antiplatelet agents. FOR CITATION: Telkova S.S., Kochetkov A.I., Gavrilova N.E., Filippova T.V., Ostroumova O.D. Anemia effect on cognitive function in patients with coronary artery disease and atrial fibrillation receiving dual antithrombotic therapy. Russian Medical Inquiry. 2025;9(9):635–644 (in Russ.). DOI: 10.32364/2587-6821-2025-9-9-14
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".