@article {Rahmane1309作者={艾尔维a·拉赫曼和乔纳森Michaud和苏菲戴尔{\ textquoteright} Aniello和艾丽卡。穆迪和詹姆斯·m·Brophy玛德琳杜兰和杰森·r·哈德角海恩尼斯主街Guertin让{\ c c} ois Boivin和Christel Renoux}, title ={口服抗凝血剂和痴呆的风险在非瓣膜性房颤患者},体积={100}={12},页面= {e1309——e1320} = {2023}, doi = {10.1212 / WNL。出版商0000000000206748}= {Wolters Kluwer健康,公司代表美国神经病学学会},在非瓣膜性房颤文摘={背景和目标(NVAF)与老年痴呆症的风险增加相关。半岛投注体育官网口服抗凝剂(OACs) NVAF中风的预防至关重要,而研究表明老年痴呆症可能的保护作用。然而,结果不一致,由于方法论上的局限。因此,我们评估是否使用OACs与NVAF患者减少老年痴呆症的发病率。此外,我们的累积时间的影响进行了探讨OAC用于老年痴呆症的发病率。方法使用英国临床实践研究数据链接,我们成立了一个队列的患者年龄在50岁以上的事故诊断NVAF OAC之前在1988年和2017年之间,没有使用,直到2019年随访。病人被认为是未曝光,直到6个月后他们的第一个OAC处方延迟考虑暴露之后,直到后续的结束。我们使用时间Cox回归模型来估计风险比率(小时),调整为54,与95 \ % CIs痴呆与OAC使用,而不使用。我们也评估风险是否随累积OAC期间使用,而不使用,通过比较判断风险类别定义的时变的方式和通过建模人力资源使用限制三次样条。结果NVAF的对象包括142227名患者,8023例老年痴呆症在662667人年的随访(发病率12.1,95 \ % CI 11.9 {\ textendash} 12.4每1000人每年)。OAC使用减少痴呆的风险(HR 0.88, 95 \ % CI 0.84 {\ textendash} 0.92)而不使用。 A restricted cubic spline also indicated a decreased risk of dementia, reaching a low at approximately 1.5 years of cumulative OAC use and stabilizing thereafter. Moreover, OAC use decreased the risk in patients aged 75 years and older (HR 0.84, 95\% CI 0.80{\textendash}0.89), but not in younger patients (HR 0.99, 95\% CI 0.90{\textendash}1.10).Discussion In patients with incident NVAF, OACs were associated with a decreased risk of dementia, particularly in elderly individuals. This warrants consideration when weighing the risks and benefits of anticoagulation in this population.Classification of Evidence This study provides Class II evidence that in patients with NVAF, OAC use (vs nonuse) is associated with a decreased risk of dementia.AF=atrial fibrillation; BMI=body mass index; CPRD=Clinical Practice Research Datalink; DOAC=direct oral anticoagulant; HRs=hazard ratios; IPCW=inverse probability of censoring weighting; NNT=number needed to treat; NVAF=nonvalvular atrial fibrillation; OAC=oral anticoagulant; PS=propensity score; VKA=vitamin K antagonist}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/100/12/e1309}, eprint = {//www.ebmtp.com/content/100/12/e1309.full.pdf}, journal = {Neurology} }