(Alden Chadwick, Wikimedia Commons
25 October 2017. People with irregular heart rhythms given anti-coagulation drugs to reduce their risk of stroke were also less likely to develop dementia than their counterparts not receiving blood-thinners. Findings from this study conducted by researchers at Karolinska Institutet in Stockholm, Sweden appear in yesterday’s issue of the European Heart Journal.
The team of Karolinska medical researchers Leif Friberg and Mårten Rosenqvist sought to find evidence of anti-coagulation drugs in protecting against development of dementia in patients with atrial fibrillation, irregular heart rhythms that can lead to blood clots, heart failure, and stroke. Friberg and Rosenqvist cite a number of studies showing a greater likelihood of people with atrial fibrillation to develop dementia. But the authors also note that evidence of anti-coagulants influencing the development of dementia in irregular heart rhythm patients is so far inconclusive.
The researchers tapped into data collected about patients in Sweden to find more conclusive evidence. The authors reviewed medical records from Sweden’s patient registry, with data on hospitalizations, and the country’s drug registry, collecting data on prescriptions to individuals, with records from both databases linked by Sweden’s unique civic registration identifiers. From these databases, the researchers collected data on more than 444,000 individuals diagnosed with atrial fibrillation and no previous history of dementia from 2006 to 2014.
Among these individuals, Friberg and Rosenqvist identified patients receiving anti-coagulant drugs and those that did not, and looked for any subsequent diagnosis of dementia. The researchers also looked into the type of anti-coagulant drug, Warfarin or newer types of blood-thinners. Anti-coagulants work by reducing the blood’s ability to thicken and form clots, which reduces the risk of clots that can cause stroke or heart attacks, but can also make it more difficult to stop bleeding.
The authors found less than half (46%) of the persons in their sample took anti-coagulation drugs, with only 3 percent of the total taking drugs other than Warfarin. Individuals taking anti-coagulants reported a lower rate of dementia than their counterparts not taking these drugs. The researchers calculate atrial fibrillation patients taking anti-coagulants have a 29 percent lower risk of developing dementia than individuals who do not take the drugs. The data also show starting the treatments earlier further lowers the risk for dementia. In addition, the team found no difference between Warfarin and newer anti-coagulants after controlling for differences in the samples.
Friberg and Rosenqvist point out that their data report a correlation or association between anti-coagulant drugs and less dementia among this population, not a cause-and-effect relationship. The researchers also note that individuals taking anti-coagulants were generally younger and healthier than patients not taking the drugs.
The authors believe the findings provide more evidence for physicians to prescribe anti-coagulants to patients with irregular heart rhythms, and to urge their patients to stick with the drugs. “Doctors should explain to their patients how these drugs work and why they should use them,” says Friberg in a Karolinska Institutet statement. “No brain can withstand a constant bombardment of microscopic clots in the long run.”
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- EU Project to Develop More Versatile Heart Pacemakers
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