Title | Treatment of Atrial Fibrillation in Patients with Dementia: A Cohort Study from the Swedish Dementia Registry. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Subic, A, Cermakova, P, Religa, D, Han, S, von Euler, M, Kåreholt, I, Johnell, K, Fastbom, J, Bognandi, L, Winblad, B, Kramberger, MG, Eriksdotter, M, Garcia-Ptacek, S |
Journal | J Alzheimers Dis |
Volume | 61 |
Issue | 3 |
Pagination | 1119-1128 |
Date Published | 2018 |
ISSN | 1875-8908 |
Keywords | Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Dementia, Female, Hemorrhage, Humans, Longitudinal Studies, Male, Registries, Risk Factors, Stroke, Survival Analysis, Sweden, Warfarin |
Abstract | BACKGROUND: Patients with dementia might have higher risk for hemorrhagic complications with anticoagulant therapy prescribed for atrial fibrillation (AF). OBJECTIVE: This study assesses the risks and benefits of warfarin, antiplatelets, and no treatment in patients with dementia and AF. METHODS: Of 49,792 patients registered in the Swedish Dementia Registry 2007-2014, 8,096 (16%) had a previous diagnosis of AF. Cox proportional hazards models were used to calculate the risk for ischemic stroke (IS), nontraumatic intracranial hemorrhage, any-cause hemorrhage, and death. RESULTS: Out of the 8,096 dementia patients with AF, 2,143 (26%) received warfarin treatment, 2,975 (37%) antiplatelet treatment, and 2,978 (37%) had no antithrombotic treatment at the time of dementia diagnosis. Patients on warfarin had fewer IS than those without treatment (5.2% versus 8.7%; p CONCLUSIONS: Warfarin treatment in Swedish patients with dementia is associated with lower risk of IS and mortality, and a small increase in any-cause hemorrhage. This study supports the use of warfarin in appropriate cases in patients with dementia. The low percentage of patients on warfarin treatment indicates that further gains in stroke prevention are possible. |
DOI | 10.3233/JAD-170575 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 29286925 |
PubMed Central ID | PMC5798527 |