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Article: Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials

TitleOral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
Authors
KeywordsAnticoagulant
Direct oral anticoagulants
Warfarin
Atrial fibrillation
Dementia
Issue Date2019
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/neubiorev
Citation
Neuroscience & Biobehavioral Reviews, 2019, v. 96, p. 1-9 How to Cite?
AbstractAtrial fibrillation (AF) is a documented risk factor for dementia. However, it is unclear whether oral anticoagulant (OAC) treatment can reduce the development of dementia or cognitive impairment. We conducted a systematic review and meta-analysis of the association between OAC use and subsequent dementia development in AF patients by searching databases from their inception to February 2018 without language restriction. Six studies (one randomized controlled trial and five observational studies) met the inclusion criteria. The pooled adjusted risk ratios (RRs) suggested a protective effect of OAC use in reducing dementia risk (RR 0.79 [95% CI: 0.67 – 0.93], I2 = 59.7%; P = 0.005). Further, high percentage of time in therapeutic range (TTR) was associated with a decreased risk of dementia (RR 0.38 [95% CI 0.22-0.64], I2 = 81.8%; P < 0.001). Our results support the hypothesis that AF-related dementia may be due to silent brain infarcts and micro-embolism that could be prevented by OAC use. Future studies with prospective follow-up with direct comparison of vitamin K antagonists and direct oral anticoagulants are needed.
Persistent Identifierhttp://hdl.handle.net/10722/278592
ISSN
2017 Impact Factor: 8.037
2015 SCImago Journal Rankings: 5.290

 

DC FieldValueLanguage
dc.contributor.authorMongkhon, P-
dc.contributor.authorNaser, AY-
dc.contributor.authorNaser, L-
dc.contributor.authorTse, G-
dc.contributor.authorLau, WCY-
dc.contributor.authorWong, ICK-
dc.contributor.authorKongkaew, C-
dc.date.accessioned2019-10-21T02:10:23Z-
dc.date.available2019-10-21T02:10:23Z-
dc.date.issued2019-
dc.identifier.citationNeuroscience & Biobehavioral Reviews, 2019, v. 96, p. 1-9-
dc.identifier.issn0149-7634-
dc.identifier.urihttp://hdl.handle.net/10722/278592-
dc.description.abstractAtrial fibrillation (AF) is a documented risk factor for dementia. However, it is unclear whether oral anticoagulant (OAC) treatment can reduce the development of dementia or cognitive impairment. We conducted a systematic review and meta-analysis of the association between OAC use and subsequent dementia development in AF patients by searching databases from their inception to February 2018 without language restriction. Six studies (one randomized controlled trial and five observational studies) met the inclusion criteria. The pooled adjusted risk ratios (RRs) suggested a protective effect of OAC use in reducing dementia risk (RR 0.79 [95% CI: 0.67 – 0.93], I2 = 59.7%; P = 0.005). Further, high percentage of time in therapeutic range (TTR) was associated with a decreased risk of dementia (RR 0.38 [95% CI 0.22-0.64], I2 = 81.8%; P < 0.001). Our results support the hypothesis that AF-related dementia may be due to silent brain infarcts and micro-embolism that could be prevented by OAC use. Future studies with prospective follow-up with direct comparison of vitamin K antagonists and direct oral anticoagulants are needed.-
dc.languageeng-
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/neubiorev-
dc.relation.ispartofNeuroscience & Biobehavioral Reviews-
dc.subjectAnticoagulant-
dc.subjectDirect oral anticoagulants-
dc.subjectWarfarin-
dc.subjectAtrial fibrillation-
dc.subjectDementia-
dc.titleOral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials-
dc.typeArticle-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.authorityWong, ICK=rp01480-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.neubiorev.2018.10.025-
dc.identifier.pmid30391408-
dc.identifier.scopuseid_2-s2.0-85056655865-
dc.identifier.hkuros308227-
dc.identifier.volume96-
dc.identifier.spage1-
dc.identifier.epage9-
dc.publisher.placeUnited Kingdom-

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