TY  - JOUR
ID  - discovery10089049
VL  - 17
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
JF  - Heart Rhythm
Y1  - 2020/05//
N2  - Background:
Whether oral anticoagulation (OAC) can prevent dementia or cognitive impairment (CI) in patients with atrial fibrillation (AF) remains unclear.

Objective:
The purpose of this study was to investigate the risk of dementia/CI among AF patients with and without OAC treatment.

Methods:
We conducted a retrospective cohort study using United Kingdom (UK) primary care data (2000?2017). Participants with newly diagnosed AF without a history of dementia/CI were identified. Inverse probability of treatment weights based on propensity scores and Cox regression were used to compare the dementia outcomes.

Results:
Among 84,521 patients with AF, 35,245 were receiving OAC treatment and 49,276 received no OAC treatment; of these patients, 29,282 were receiving antiplatelets. Over a mean follow-up of 5.9 years, 5295 patients developed dementia/CI. OAC treatment was associated with a lower risk of dementia/CI compared to no OAC treatment (hazard ratio [HR] 0.90; 95% confidence interval 0.85?0.95; P <.001) or antiplatelets (HR 0.84; 95% confidence interval 0.79?0.90; P <.001). No significant difference in dementia risk was observed for direct oral anticoagulants (DOACs) vs warfarin (HR 0.89; 95% confidence interval 0.70?1.14; P = .373), whereas dual therapy (OAC plus an antiplatelet agent) was associated with a higher risk of dementia/CI compared with no treatment (HR 1.17; 95% confidence interval 1.05?1.31; P = .006).

Conclusion:
OAC use was associated with a lower risk of dementia/CI compared to non-OAC and antiplatelet treatment among AF patients. The evidence for DOAC on cognitive function is insufficient, and further studies including randomized clinical trials are warranted.
SP  - 706
A1  - Mongkhon, P
A1  - Fanning, L
A1  - Lau, WCY
A1  - Tse, G
A1  - Lau, KK
A1  - Wei, L
A1  - Kongkaew, C
A1  - Wong, ICK
IS  - 5 Part A
SN  - 1547-5271
EP  - 713
AV  - public
TI  - Oral anticoagulant and reduced risk of dementia in patients with atrial fibrillation: A population-based cohort study
UR  - https://doi.org/10.1016/j.hrthm.2020.01.007
PB  - Elsevier
ER  -