Comparing the risk of dementia in subjects with atrial fibrillation using non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists: a Belgian nationwide cohort study

Grymonprez, Maxim; Petrovic, Mirko; Backer, Tine L. De; Ikram, M. Arfan; Steurbaut, Stéphane; Lahousse, Lies

doi:10.1093/ageing/afad038

Cited by 10 publications

(1 citation statement)

References 36 publications

(77 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…В наблюдательное исследование, проведенное в Бельгии, включены 237 012 пациентов с ФП в период с 2013 по 2019 г. [35]. Применение НОАК ассоциировалось со снижением риска развития деменции (95% ДИ 0,85-0,98) в сравнении с приемом АВК.…”

Section: профилактика инсульта и кн при фп на основе антикоагулянтной...unclassified

Cognitive disorders in patients with atrial fibrillation: A review

Parfenov

2023

Consilium Medicum

View full text Add to dashboard Cite

Cognitive disorders (CD) represent one of the leading causes of disability among the elderly. Atrial fibrillation (AF) is an independent and corrected risk factor for CD and dementia. The development of CD with AF is associated with the occurrence of cerebral infarcts, silent infarcts, cerebral micro and macro hemorrhages, a cerebral small vessels disease, cerebral hypoperfusion, and comorbid neurodegenerative disease. The prevention of the first and recurrent ischemic stroke (IS) is the leading importance in preventing the development and progression of the CD in AF, which include the use of the vitamin K antagonists (VKA) and new oral anticoagulants (the NOACs apixaban, dabigatran, rivaroxaban, edoxaban), control of arterial pressure and other methods of prevention. The use of the NOACs is more effective than using VKA, reduces the risk of CD and dementia. The use of individual NOACs, various methods for the prevention of CD and Alzheimer's disease in patients with AF are discussed.

show abstract

Section: профилактика инсульта и кн при фп на основе антикоагулянтной...unclassified

Cognitive disorders in patients with atrial fibrillation: A review

Parfenov

2023

Consilium Medicum

View full text Add to dashboard Cite

show abstract

Dementia risk reduction between DOACs and VKAs in AF: A systematic review and meta‐analysis

Chokesuwattanaskul,

Prasitlumkum,

Cooley

et al. 2024

Journal of Arrhythmia

View full text Add to dashboard Cite

IntroductionDirect oral anticoagulants (DOACs) become the recommended treatment over vitamin K antagonists (VKA) in patients with non‐valvular atrial fibrillation (AF). However, their effectiveness in reducing cognitive impairment and dementia compared to VKA remains unclear.MethodsA systematic literature search was conducted on Ovid MEDLINE, EMBASE, and Cochrane Database. Randomized controlled trials, cohort, or case–control study that assessed incident dementia between AF patients who received DOAC compared to VKA were selected. Relevant study characteristics and the number of incident dementia diagnosis or hazard ratios (HRs) for incident dementia and each dementia subtypes were extracted. Random‐effects model was used to perform meta‐analysis. Standardized mean differences (SMDs) were used to estimate effect sizes for continuous data.ResultsTwelve cohort studies comprising 1 451 069 individuals were included. The incidence of dementia was lower in AF patients prescribed DOACs compared to VKA (HR 0.88, 95% CI 0.83–0.93, I2 = 61.2%). A lower incident dementia in DOACs group relative to VKA was significantly observed in those less than 75 years of age (< 65 years, HR 0.83 (95% CI 0.72–0.97, I2 = 0%); 65–74 years, HR 0.86 (95% CI 0.81–0.92, I2 = 55.4%); and ≥ 75 years, HR 1.07 (95% CI 0.74–1.55, I2 = 92.5%)) and for the subgroup of patients with vascular dementia (HR 0.91, 95% CI 0.824–0.997, I2 = 0%).ConclusionsThis meta‐analysis reveals a reduction in incidence of dementia in AF patients prescribed DOACs compared to VKA, particularly in those less than 75 years old and in the vascular dementia subtype.

show abstract

The role of atrial fibrillation in vascular cognitive impairment and dementia: epidemiology, pathophysiology, and preventive strategies

Fekete,

Liotta,

Molnar

et al. 2024

GeroScience

View full text Add to dashboard Cite

The aging population in Europe faces a substantial burden from dementia, with vascular cognitive impairment and dementia (VCID) being a preventable cause. Atrial fibrillation (AF), a common cardiac arrhythmia, increases the risk of VCID through mechanisms such as thromboembolism, cerebral hypoperfusion, and inflammation. This review explores the epidemiology, pathophysiology, and preventive strategies for AF-related VCID. Epidemiological data indicate that AF prevalence rises with age, affecting up to 12% of individuals over 80. Neuroimaging studies reveal chronic brain changes in AF patients, including strokes, lacunar strokes, white matter hyperintensities (WMHs), and cerebral microbleeds (CMHs), while cognitive assessments show impairments in memory, executive function, and attention. The COVID-19 pandemic has exacerbated the underdiagnosis of AF, leading to an increase in undiagnosed strokes and cognitive impairment. Many elderly individuals did not seek medical care due to fear of exposure, resulting in delayed diagnoses. Additionally, reduced family supervision during the pandemic contributed to missed opportunities for early detection of AF and related complications. Emerging evidence suggests that long COVID may also elevate the risk of AF, further complicating the management of this condition. This review underscores the importance of early detection and comprehensive management of AF to mitigate cognitive decline. Preventive measures, including public awareness campaigns, patient education, and the use of smart devices for early detection, are crucial. Anticoagulation therapy, rate and rhythm control, and addressing comorbid conditions are essential therapeutic strategies. Recognizing and addressing the cardiovascular and cognitive impacts of AF, especially in the context of the COVID-19 pandemic, is essential for advancing public health.

show abstract

Comparing the risk of dementia in subjects with atrial fibrillation using non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists: a Belgian nationwide cohort study

Cited by 10 publications

References 36 publications

Cognitive disorders in patients with atrial fibrillation: A review

Cognitive disorders in patients with atrial fibrillation: A review

Dementia risk reduction between DOACs and VKAs in AF: A systematic review and meta‐analysis

The role of atrial fibrillation in vascular cognitive impairment and dementia: epidemiology, pathophysiology, and preventive strategies

Contact Info

Product

Resources

About