Physicians' Academy for Cardiovascular Education

AF patients receiving oral anticoagulation have a lower risk of dementia

Less dementia with oral anticoagulation in atrial fibrillation

Friberg L & Rosenqvist M. - Eur Heart J 2017; published online ahead of print

Background

Atrial fibrillation (AF) is associated with an increased risk for stroke, which is significantly reduced by OAC therapy. AF is also associated with dementia, but it is unclear whether OAC therapy is useful for the prevention of dementia, since available studies led to conflicting results [1-4].

In this retrospective cohort study, the incidence of dementia among AF patients with and without OAC treatment was evaluated, using data from the Swedish Patient register and the Dispensed Drug register [5,6]. It was also assessed whether there is a difference between novel anticoagulants and warfarin in this context.

All individuals with a diagnosis of AF between 2006 and 2014 and without a history of dementia were included in the analysis. Information within 30 days after the first contact was used as baseline condition. New dementia during follow-up was detected from day 31 within the time at risk. 444106 patients were included in the study. During over 1.5 million years of follow-up, 26 210 patients were diagnosed with dementia, corresponding to 1.73 per 100 patient years at risk (PYAR).

Main results

Conclusion

In a large retrospective cohort study, the risk of dementia was higher without oral anticoagulant treatment in patients with AF, compared with AF patients receiving oral anticoagulation. These results suggest that early initiation of anticoagulant treatment in patients with AF could contribute to preservation of cognitive function.

References

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Find this article online at Eur Heart J