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

© 2018 Elsevier Ltd Atrial 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 u...

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Main Authors: Pajaree Mongkhon, Abdallah Y. Naser, Laura Fanning, Gary Tse, Wallis C.Y. Lau, Ian C.K. Wong, Chuenjid Kongkaew
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/62940
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-629402018-12-14T03:42:05Z Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials Pajaree Mongkhon Abdallah Y. Naser Laura Fanning Gary Tse Wallis C.Y. Lau Ian C.K. Wong Chuenjid Kongkaew Neuroscience Psychology © 2018 Elsevier Ltd Atrial 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. 2018-12-14T03:41:49Z 2018-12-14T03:41:49Z 2019-01-01 Journal 18737528 01497634 2-s2.0-85056655865 10.1016/j.neubiorev.2018.10.025 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85056655865&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/62940
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Neuroscience
Psychology
spellingShingle Neuroscience
Psychology
Pajaree Mongkhon
Abdallah Y. Naser
Laura Fanning
Gary Tse
Wallis C.Y. Lau
Ian C.K. Wong
Chuenjid Kongkaew
Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
description © 2018 Elsevier Ltd Atrial 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.
format Journal
author Pajaree Mongkhon
Abdallah Y. Naser
Laura Fanning
Gary Tse
Wallis C.Y. Lau
Ian C.K. Wong
Chuenjid Kongkaew
author_facet Pajaree Mongkhon
Abdallah Y. Naser
Laura Fanning
Gary Tse
Wallis C.Y. Lau
Ian C.K. Wong
Chuenjid Kongkaew
author_sort Pajaree Mongkhon
title Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
title_short Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
title_full Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
title_fullStr Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
title_full_unstemmed Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials
title_sort oral anticoagulants and risk of dementia: a systematic review and meta-analysis of observational studies and randomized controlled trials
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85056655865&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/62940
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