AF Patients Taking OACs Have Lower Dementia Risk

June 14, 2019

Low-risk atrial fibrillation patients who take oral anticoagulants have a lower risk of dementia than those who do not, a study says.

Older, low-risk atrial fibrillation (AF) patients who take oral anticoagulants (OACs) have a lower risk of dementia than those who do not, a recent study says. However, the risks outweigh this benefit in patients under age 60.

The study, published May 16 in European Heart Journal, was conducted to discover if there was a link between reduced dementia and anticoagulants.  “Recent observational studies have shown that AF patients using oral anticoagulant drugs have almost half as high risk of dementia as AF patients not using OAC,” the authors write. The researchers are from the Karolinska Institute in Stockholm.

“From a global brain protection perspective, ie, with the objective to shield the brain from dementia as well as from embolic stroke and intracerebral bleedings (ICHs), it is possible that low-risk patients would be better off with OAC than without,” the researchers added.

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The study results come from a retrospective study of cross-matched national registries of all individuals in Sweden with a hospital diagnosis of AF between 2006 and 2014. Of the 91,254 patients included in the study, 43% used OAC at baseline.

Treatment with OAC was associated with lower risk of dementia after adjustment for death as a competing risk. OAC treatment was associated with an overall 12% lower risk when the composite brain protection endpoint was evaluated.

“This apparent benefit was restricted to patients over 65  years old, whereas OAC treatment of patients below 60  years of age without risk factors appeared to do more harm than good,” they write.

“The brains of AF patients over 65  years appeared to fare better with OAC than without OAC, irrespective of other risk factors. If this observation holds true and can be confirmed by others, counting of risk scores may not be needed in order to decide whether to offer OAC or not since age alone is enough to tip the balance in favor of treatment (unless there are strong reasons against),” the authors write.