healio.com/cardiology/arrhy...
“Our study suggests that the strong link between atrial fibrillation and dementia could be weakened if patients took oral anticoagulants. Therefore, doctors should think carefully and be readier to prescribe anticoagulants for atrial fibrillation patients to try to prevent dementia.”
- Gregory Y.H. Lip, MD, FRCP, DFM, FACC, FESC
Push for anticoagulation then? I know this has been highlighted before but at least this article calls them anticoagulants!!
I'm relieved if that's the case and anticoagulants help. One can only hope!
Yes, anticoagulants do reduce the risk of dementia. That has been shown in trials previously, e.g.
medscape.com/viewarticle/90...
Also that the time in therapeutic range (TTR) is very important for those taking warfarin:
ncbi.nlm.nih.gov/pubmed/293...
If you look at the graph, those in the 72%-100% TTR category have only a third of the risk of dementia as those who aren't on anticoagulants.
It is not easy to understand what "72%-100% TTR category" means. Maybe it refers to how much warfarin is taken compared with the amount required to keep the blood in the best or optimum condition in those with AF. With other anticoagulants one takes one or two tablets per day, so "72%-100% TTR category" seems meaningless.
The 72%-100% TTR category refers to the % of INR tests that are in the recommended range of 2-3. It only applies to warfarin, which is the only anticoagulant where the effect can actually be measured. For instance, I test my INR every 2 weeks. Over the last 10 years, I've had about 3 results that are out of range (and then only marginally), so my TTR is around 99%.
DOACs cannot have their effectiveness tested. This is claimed as a benefit as "testing is not required". However there have been reports that the ability to test them would improve their performance.
Yes I read that and that it was abandoned as it would push up tbe overall cost!!
The therapeutic range of warfarin is narrow and can beeasily disturbed! Depending if you have your own machine and / or have regular checks at clinic it can be calculated what percentage of the time you are in therapeutic range. With newer anticoagulants fewer outside i fluences affect them and if you are taking them as prescribed your "cover" should be better. Some people like my OH have an enviable percentage TTR on warfarin. Others are not so fortunate
I'm pleased you raised this topic. My husband (af) many years and on apixaban for about 5 years now has what they think is vascular dementia. So he hasn't had a stroke but isn't vascular little bleeds on the brain? He is too weak to have scans so the diagnosis has been done by g.p. We are waiting for further blood tests. So has anyone else experience a relative in this situation. It has been quite a shock!
Vascular dementia can be caused by plaques in the arteries in the brain similar to those which cause narrowing in the heart and leg arteries. All you can do is keep calm and carry on. My OH has signs of vascular dementia and already has stents for MI and peripheral arterial disease so would make sense. Anticoagulation also makes sense for my OH as he has permanent AF.
I wanted to add a like to your piece but the system just removed the like you already had- I wanted to know that I liked yr contribution and will bear it in mind now I've agreed to take the low dose of anticoagulant (I corrected the cardiologist I saw very briefly on that one!)
Hi Bagrat. Do they recommend anticoagulants following successful ablation? We are still prone to blips but not necessarily AF in the form of PAF, or persistent.
Interesting! My mother is on hospice now for end stage chf at 93 yrs old and was taken off apixaban for about 2 months now. She’s had afib for over 30 yrs. The hospice doctor felt it was more of a risk for bleeding at this point. Since she’s been off, I have noticed more forgetfulness. In fact I would almost say at this point she is MCI.
Could you explain MCI nymima01 please. Sorry to be unawste of it's meaning.
Towards the end of life our normal brainfilters don't work so will. Usually in health we can differentiate between reality and imagination, past and present, waking and sleeping. When unwell these filters are imperfect and contribute to what those alongside the poorly person may call confusion or memory loss
Reducing Risk of Stroke When You Have Atrial Fibrillation - Evidence Update for Patients
Tachycardia causes AF?
Medscape (AF and alcohol, for info)
Blood Thinners and AF
Cardioneuroablation For AF
