AFib patients face comparable dementia risk with DOACs and warfarin
Patients with atrial fibrillation (AFib) who take direct oral anticoagulants (DOAC) and warfarin are at a similar risk of developing dementia, according to new data published in Stroke.
Using the Korean nationwide claims database, the authors analyzed oral anticoagulant–naive nonvalvular AFib patients 40 years or older. Patients were treated from January 2014 to December 2017.
The study included a total of 72,846 patients, including 25,948 treated with warfarin and 46,898 treated with DOACs. The DOAC group was broken down so that 17,193 were given rivaroxaban, 9,882 were given dabigatran, 11,992 were given apixaban and 7,831 were given edoxaban. The warfarin and DOAC groups were balanced utilizing the inverse probability of treatment weighting method.
Fifty-eight percent of the patient population were men, and the mean patient age was 71.8 years old.
Compared with patients treated with warfarin, those who were given DOACs tended to be older and had a higher CHA2 DS2 -VASc score.
The authors also found that during a mean 1.3 years of follow-up, the rate of crude incidence of dementia was 4.87 per 100 person-years. The rate of vascular dementia was 1.2 per 100 person-years, meanwhile, and the rate of Alzheimer dementia was 3.3 per 100 person-years.
DOAC and warfarin were associated with similar risks of developing dementia in all instances.
“In our study, the pooled DOAC group did not show a significant difference in the risk of dementia compared with warfarin, consistent with previous results,” wrote lead author So-Ryoung Lee, MD, department of internal medicine at Seoul National University Hospital, Republic of Korea, and colleagues. “In subgroup analyses, among age subgroups, DOAC showed a lower risk of dementia than warfarin only in patients aged 65 to <75 years, consistent with previous studies."
Read the full study here.