Notes sur les tags :
Réaliser des modifications :
Pour modifier ce document, il est nécessaire d'être connecté au site. Pour cela, assurez-vous d'avoir des identifiants valides. Si vous n'en avez pas,
contactez-nous. Pour vous connecter, cliquez sur l'icône
dans la barre de navigation.
Résumé et points clés
Atrial fibrillation (AF) patients are more susceptible to dementia, but the results about the effect of oral anticoagulants (OACs) on the risk of dementia are not consistent. We hypothesize that OAC is associated with a reduced risk of dementia with AF and that nonvitamin K antagonist oral anticoagulants (NOAC) are superior to vitamin K antagonists (VKA). Four databases were systematically searched until July 1, 2022. Two reviewers independently selected literature, evaluated quality, and extracted data. Data were examined using pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Fourteen research studies involving 910 patients were enrolled. The findings indicated that OACs were associated with a decreased risk of dementia (pooled HR: 0.68, 95% CI: 0.55-0.82, I(2) = 87.7%), and NOACs had a stronger effect than VKAs (pooled HR: 0.87, 95% CI: 0.79-0.95, I(2) = 72%), especially in participants with a CHA2DS2VASc score ≥ 2 (pooled HR: 0.85, 95% CI: 0.72-0.99). Subgroup analysis demonstrated no statistical significance among patients aged <65 years old (pooled HR: 0.83, 95% CI: 0.64-1.07), patients in "based on treatment" studies (pooled HR: 0.89, 95% CI: 0.75-1.06), or people with no stroke background (pooled HR: 0.90, 95% CI: 0.71-1.15). This analysis revealed that OACs were related to the reduction of dementia incidence in AF individuals, and NOACs were better than VKAs, remarkably in people with a CHA2DS2VASc score ≥ 2. The results should be confirmed by further prospective studies, particularly in patients in "based on treatment" studies aged <65 years old with a CHA2DS2VASc score < 2 or without a stroke background.
Références de l'article
- A comparison of the effects of NOAC and VKA therapy on the incidence of dementia in patients with atrial fibrillation: A systematic review and meta-analysis.
- A comparison of the effects of NOAC and VKA therapy on the incidence of dementia in patients with atrial fibrillation: A systematic review and meta-analysis.
- Wang W, Fan W, Su Y, Hong K
- Clinical cardiology
- 2023
- Clin Cardiol. 2023 Aug;46(8):866-876. doi: 10.1002/clc.24076. Epub 2023 Jun 27.
- Humans, Aged, Anticoagulants/adverse effects, *Atrial Fibrillation/complications/diagnosis/drug therapy, Incidence, Administration, Oral, Prospective Studies, *Stroke/epidemiology/etiology/prevention & control, *Dementia/diagnosis/epidemiology/prevention & control, Vitamin K
- Sans_Catégorie, Neurocognitif, Revue_systématique, Méta_analyse
- Liens
- Traduction automatique en Français sur Google Translate
- DOI: 10.1002/clc.24076
- PMID: 37366141
- Articles similaires
- Cité par
- Références
- Texte complet gratuit
- Twitter
- Twitter cet article (lien vers l'article)
- Twitter cet article (lien vers cette page)
Éditer la discussion
Références