English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Open

Presents the pdf analysis as premium feature

PDF Analysis

Insights

Presents the summarisation as premium feature

Summarisation

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Background  The mechanisms behind the association of atrial fibrillation ( AF ) and dementia are unknown. We previously found a significantly increased risk of dementia in  AF  patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which  AF  itself increases dementia risk, in addition to long‐term anticoagulation exposure.    Methods and Results  A total of 10 537 patients anticoagulated with warfarin (target  INR  2–3), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included. Warfarin indication was for  AF  (n=4460), thromboembolism (n=5868), and mechanical heart valve(s) (n=209). Patients in the latter 2 categories were included only if they had no prior history of  AF . The primary outcome was dementia. Patients with  AF  were older and had higher rates of hypertension, diabetes, heart failure, and stroke.  AF  patients experienced higher rates of total dementia (5.8% versus 1.6%,  P <0.0001), Alzheimer disease (2.8% versus 0.9%,  P <0.0001), and vascular dementia (1.0% versus 0.2%,  P <0.0001). A propensity analysis of 6030 patients was performed to account for baseline demographics differences. Long‐term risk of dementia remained significant in  AF  patients compared with matched non‐ AF  patients (total dementia: hazard ratio [HR]=2.42 [1.85–3.18],  P <0.0001; Alzheimer:  HR =2.04 [1.40–2.98],  P <0.0001; senile:  HR =2.46 [1.58–3.86],  P <0.0001). Low percent therapeutic range compared with a higher percent therapeutic range was associated with dementia risk in both  AF  (26–50% versus >75%:  HR =2.51,  P =0.005) and non‐ AF  groups (≤25% versus >75%:  HR =3.92,  P <0.0001).    Conclusions  The presence of  AF  significantly increases risk of dementia, including Alzheimer's disease, compared with matched patients receiving warfarin anticoagulation for other reasons. Quality of anticoagulation management remains an important risk factor for dementia in all patients.

journal of the american heart association

Atrial Fibrillation Patients Treated With Long‐Term Warfarin Anticoagulation Have Higher Rates of All Dementia Types Compared With Patients Receiving Long‐Term Warfarin for Other Indications