SynthesisMedicine2019
Anticoagulation in atrial fibrillation and cognitive decline: A systematic review and meta-analysis.
Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Risk of dementia in patients with atrial fibrillation: Short versus long follow-up. A systematic review and meta-analysis.International journal of geriatric psychiatry · 2021Pooled it
- Psychological aspects of atrial fibrillation: A systematic narrative review : Impact on incidence, cognition, prognosis, and symptom perception.Current cardiology reports · 2020Pooled it
- Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study.PLoS medicine · 2019Pooled it
- Feasibility of identifying factors related to Alzheimer's disease and related dementia in real-world data.JAMIA open · 2026Review
- Atrial Fibrillation and Cognitive Decline: A Systematic Review of Pathophysiological Mechanisms, Therapeutic Strategies, and Digital Health Technologies in Neuroprotection.Journal of clinical medicine · 2026Review
- Post-procedural anticoagulation enhances cognitive function and reduces stroke risk in atrial fibrillation patients after left atrial appendage occlusion.American journal of translational research · 2025Article
- Exploring the Link between Anticoagulation, Cognitive Impairment and Dementia in Atrial Fibrillation: A Systematic Review.Journal of clinical medicine · 2024Review
- Discontinuation of oral anticoagulant use among nursing home residents with atrial fibrillation before hospice enrollment.Journal of the American Geriatrics Society · 2023Article
- The neurocognitive effects of atrial fibrillation: benefits of the ABC pathway.European heart journal. Cardiovascular pharmacotherapy · 2023Review
- Anticoagulants and Dementia: A Systematic Review.Cureus · 2023Review
- Review
- Impact of cognitive impairment on clinical outcomes in elderly patients with atrial fibrillation: ANAFIE Registry.BMJ neurology open · 2023Article
- Is catheter ablation associated with preservation of cognitive function? An analysis from the SAGE-AF observational cohort study.Frontiers in neurology · 2023Article
- Direct Oral Anticoagulants (DOACs) for Therapeutic Targeting of Thrombin, a Key Mediator of Cerebrovascular and Neuronal Dysfunction in Alzheimer's Disease.Biomedicines · 2022Review
- Combination of ablation and left atrial appendage closure as "One-stop" procedure in the treatment of atrial fibrillation: Current status and future perspective.Pacing and clinical electrophysiology : PACE · 2021Review
- The contact activation system and vascular factors as alternative targets for Alzheimer's disease therapy.Research and practice in thrombosis and haemostasis · 2021Article
- Age-Related Male Hypogonadism and Cognitive Impairment in the Elderly: Focus on the Effects of Testosterone Replacement Therapy on Cognition.Geriatrics (Basel, Switzerland) · 2020Review
- Cognitive Function and Atrial Fibrillation: From the Strength of Relationship to the Dark Side of Prevention. Is There a Contribution from Sinus Rhythm Restoration and Maintenance?Medicina (Kaunas, Lithuania) · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is well known that atrial fibrillation (AF) carried a high risk of cognitive decline, which is independent of stroke or transient ischemic attack (TIA). Whether anticoagulation is associated with reduced risk of cognitive decline in participants with AF still remains controversial. We conducted a systematic review and meta-analysis to explore the effect of anticoagulation on the risk of cognitive decline in patients with AF.
methodsWe systematically searched the PubMed, Embase and the Cochrane Database for eligible studies published up to January 2018. Risk ratios (RR) with 95% confidence interval (CI) for cognitive decline were extracted, and pooled estimations were calculated using the fixed effects model. Subgroup analyses were further performed.
resultsEight relevant articles involved 454,273 patients were ultimately included in this meta-analysis. We found that anticoagulation was associated with reduced risk of cognitive impairment as compared with nonanticoagulation (RR 0.72, 95% CI 0.69-0.75, I 11.5%). This reduction was still significant after adjustment for stroke and TIA (RR 0.72, 95% CI 0.69-0.74, I 0.0%). In the subgroup analyses, the incidence of cognitive decline was significantly decreased in those treated with anticoagulation compared to no treatment (RR 0.72, 95% CI 0.69-0.75, I 0.0%), but the cognitive benefit showed no significant difference between anticoagulant and antiplatelet treatment (RR 1.01, 95% CI 0.68-1.50, I 46.8%).
conclusionAnticoagulation is associated with cognitive benefit in participants with AF independent of stroke and TIA, but it was not superior to antiplatelet drugs in reducing the risk of cognitive decline.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.