Takeaway
- In patients with atrial fibrillation (Afib), the use of oral anticoagulants (OACs) was associated with a lower risk for dementia/cognitive impairment (CI) compared with non-OACs and antiplatelet use.
Why this matters
- Current evidence is insufficient to determine whether direct OAC (DOACs) treatment offers a neuroprotective effect on cognition in patients with Afib and findings warrant further studies including randomised clinical trials.
Study design
- Retrospective cohort study included 84,521 patients with newly diagnosed Afib using data from The Health Improvement Network (THIN) database.
- Main outcome: composite of new-onset dementia/CI.
- Funding: University of Hong Kong Seed Fund and others.
Key results
- Of 84,521 patients with Afib, 35,245 received OAC treatment, 49,276 received no OAC treatment, and of these, 29,282 patients received antiplatelet treatment.
- Over a mean follow-up of 5.9 years, incidence rates of dementia/CI were lower in the OAC vs non-OAC group (12.1 vs 13.3 per 1000 person-years).
- OAC group had a lower risk for dementia/CI compared with non-OAC (HR, 0.90; 95% CI, 0.85-0.95; P<.001) and antiplatelet (HR, 0.84; 95% CI, 0.79-0.90; P<.001) group.
- No significant difference was observed in dementia risk between DOACs vs warfarin (HR, 0.89; 95% CI, 0.70-1.14; P=.373) group.
- Dual therapy (OAC plus antiplatelet agent) linked with a higher risk for dementia/CI compared with no treatment (HR, 1.17; 95% CI, 1.05-1.31; P=.006).
Limitations
- Retrospective design.
- Risk of residual confounding.
References
References
