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A Systematic Review and Meta-analysis to Determine the Effect of Oral Anticoagulants on Incidence of Dementia in Patients with Atrial Fibrillation
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  • Mingjie Lin,
  • Wenqiang Han,
  • Jingquan Zhong,
  • Lin Wu
Mingjie Lin
Peking University First Hospital
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Wenqiang Han
Shandong University Cheeloo College of Medicine
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Jingquan Zhong
Shandong University Cheeloo College of Medicine
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Lin Wu
Peking University First Hospital
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Abstract

Aims: To assess the effect of oral anticoagulant (OAC) administration on incidence of dementia in patients with atrial fibrillation (AF) with Systematic review and meta-analysis in according with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. Methods: We systematically searched the electronic databases including Pubmed, Embase, Cochrane library, and ClinicalTrails.gov for relevant articles. The primary outcome was the incidence of dementia. The adjusted risk ratio (RR), odds ratio, or hazard ratio were extracted and pooled by the random-effects models. Subgroup analysis was performed according to the setting observational window. Risk of bias was assessed using the Newcastle-Ottawa Scale, while publication bias was assessed by the Begg’s and Egger’s tests. Results: Nine studies included in this review (2 prospective and 7 retrospective observational studies, including 613,920 patients). The results presented the significant association between OAC therapy and the reduced risk of dementia compared with no treatment (RR [95%CI] =0.72 [0.60, 0.86], I2=97.2%; P =0.000). In the subgroup analysis, the pooled RR became statistically non-significant (including four studies, RR [95%CI] =0.75 [0.51, 1.10], I2=98.8%; P =0.000). There is no significant risk of bias and publication bias. Conclusions: This study indicated the protective effect of OAC therapy for dementia in patients with AF. However, the results are limited because of high heterogeneity, inconsistent direction of effect in subgroup analysis. Further prospective well-designed study is needed with longer follow-up duration in younger patients.

Peer review status:ACCEPTED

09 Mar 2021Submitted to International Journal of Clinical Practice
12 Mar 2021Submission Checks Completed
12 Mar 2021Assigned to Editor
12 Mar 2021Reviewer(s) Assigned
28 Mar 2021Review(s) Completed, Editorial Evaluation Pending
12 Apr 20211st Revision Received
12 Apr 2021Submission Checks Completed
12 Apr 2021Assigned to Editor
13 Apr 2021Reviewer(s) Assigned
15 Apr 2021Review(s) Completed, Editorial Evaluation Pending
19 Apr 2021Editorial Decision: Accept