Oral anticoagulants may reduce dementia risk in AF
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Patients taking oral anticoagulants had a lower risk for dementia/cognitive impairment compared with those not taking oral anticoagulants, according to a study published in HeartRhythm.
Pajaree Mongkhon, PharmD, of the Centre for Safety and Quality in Health in the department of pharmacy practice at Naresuan University in Tha Pho, Thailand, and colleagues analyzed data from 84,521 patients with atrial fibrillation who were free from dementia or cognitive impairment. The outcome of interest was a composite of new-onset dementia/cognitive impairment.
Oral anticoagulants were prescribed in 41.7% of patients. Of those who were not prescribed oral anticoagulants (n = 49,276), 29,282 were taking antiplatelets.
During a mean follow-up of 5.9 years, 6.3% of patients developed dementia/cognitive impairment. Patients taking oral anticoagulants had a lower risk for dementia/cognitive impairment compared with those not taking the treatment (HR = 0.9; 95% CI, 0.85-0.95). This association was also seen for antiplatelets (HR = 0.84; 95% CI, 0.79-0.9).
Dementia risk did not differ when direct oral anticoagulants were compared with warfarin (HR = 0.89; 95% CI, 0.7-1.14). Compared with no treatment, patients taking an oral anticoagulant with an antiplatelet agent had an increased risk for dementia/cognitive impairment (HR = 1.17; 95% CI, 1.05-1.31).
“Indeed, these results support the hypothesis that silent brain infarcts represent the mechanistic link between AF and dementia,” Mongkhon and colleagues wrote. “However, the evidence of direct oral anticoagulant treatment is currently insufficient to make a conclusion whether it provides a neuroprotective effect on cognition in patients with AF. A randomized controlled trial may be required or longer-term follow-up of direct oral anticoagulant-treated patients to understand whether there are any differences in dementia risk between direct oral anticoagulants and warfarin in AF.” – by Darlene Dobkowski
Disclosures: Mongkhon reports no relevant financial disclosure. Please see the study for all other authors’ relevant financial disclosures.
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