PT -期刊文章盟艾尔维a·拉赫曼AU -乔纳森·米肖德盟苏菲戴尔涅洛E.M.穆迪盟盟——艾丽卡- James m . Brophy AU -玛德琳杜兰盟杰森·r·哈德角海恩尼斯主街Guertin盟让-弗朗索瓦Boivin AU - Christel Renoux TI -口服抗凝血剂和痴呆的风险在非瓣膜性房颤患者援助- 10.1212 / WNL。0000000000206748 DP - 2023年3月21日TA -神经病半岛投注体育官网学PG - e1309 e1320 VI - 100 IP - 12 4099 - //www.ebmtp.com/content/100/12/e1309.short 4100 - //www.ebmtp.com/content/100/12/e1309.full所以Neurology2023 3月21日;非瓣膜性房颤100 AB -背景和目标(NVAF)与老年痴呆症的风险增加相关。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%的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%可信区间11.9 - -12.4每1000人年)。 OAC use was associated with a decreased risk of dementia (HR 0.88, 95% CI 0.84–0.92) compared with nonuse. 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 0.80–0.89), but not in younger patients (HR 0.99, 95% CI 0.90–1.10).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