Time of Initiation of Antithrombotic Therapy Linked to Dementia Risk
Delayed treatment with anticoagulants increases the risk of dementia in patients with atrial fibrillation (AF), according to the results of a new study presented at the 2017 Heart Rhythm Scientific Sessions.
The study included 6189 patients with AF and no history of anticoagulation use or dementia (mean age 69.2 years, 56.8% male). Researchers grouped patients according to when they began antithrombotic therapy after AF diagnosis: immediate (less than 30 days) or delayed (more than 30 days). The primary endpoint was incident of dementia, and pre-existing risk factors included hypertension, diabetes, heart failure, and stroke and transient ischemic attack.
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Overall, 43.6% of patients immediately started antithrombotic therapy with either aspirin or warfarin.
The researchers found that the risk of dementia was associated with time delay in initiation of antithrombotic treatment and drug therapy.
“If antithrombotic therapy was not started within 30 days versus 1 year, multivariate adjusted risk of dementia increased: hazard ratio: 1.63, p=0.05 and with relative risk directly associated with baseline risk,” they wrote.
“Delays in initiating antithrombotic therapy, in particular warfarin anticoagulation, can increase risk of dementia,” the researchers concluded. “CHADS2 Vasc score can be used to identify those at highest risk of cognitive decline with therapy delay.”
—Melissa Weiss
Reference:
Bunch TJ, May HT, Bair TL, et al. Dementia rates increase with delays in initiation of anticoagulation treatment for atrial fibrillation. Presented at: the 2017 Heart Rhythm Scientific Sessions; May 10-13, 2017; Chicago, IL.