In a new study from the University of Sao Paulo, researchers found the anticoagulant medication dabigatran yielded similar results to warfarin for the prevention of cognitive decline in older adults with atrial fibrillation after two years of treatment.
Atrial fibrillation is the most common cardiac arrhythmia in older adults, and it is associated with an increased risk of stroke, cognitive impairment and dementia.
Stroke can occur when a blood clot blocks blood flow to the brain, and oral anticoagulants, or medications that prevent the formation of blood clots such as dabigatran and warfarin, are typically prescribed to prevent stroke.
Dabigatran has been found to be comparable to warfarin for the prevention of stroke and also has a lower risk of major bleeding complications.
In the study, the team tested 200 adults over age 70 with confirmed atrial fibrillation, and about 62% of the study participants were male.
Participants were assigned to take dabigatran (110 or 150 mg twice daily) or warfarin (once daily, dose controlled based on how long it takes the blood to clot) for two years.
Patients also had a brain MRI at baseline and after two years to identify possible strokes.
Participants completed 90-minute cognitive and functional evaluations at the one-year and two-year follow-up visits.
Another MRI was performed at the end of the two-year study period to identify possible cerebrovascular events.
The researchers found that after two years:
no participant was diagnosed with dementia during the trial, and,
among the entire study population, there was less than a half-point difference between study participants taking warfarin and those taking dabigatran on scales measuring memory, executive functions, language and attention from baseline.
These findings highlight the importance of adequate anticoagulation treatment to decrease the cognitive decline in older atrial fibrillation patients.
In addition, the researchers concluded that among older patients with atrial fibrillation who were adequately treated with warfarin or dabigatran, there was no difference in cognitive outcomes after two years of treatment.
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The study was presented at the American Heart Association’s Scientific Sessions 2021. One author of the study is Bruno Caramelli, M.D.
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