Evidence map›Paper›PMID 31095295›Full record

ArticleEuropean heart journal2019

Less dementia and stroke in low-risk patients with atrial fibrillation taking oral anticoagulation.

Leif Friberg, Tommy Andersson, Mårten Rosenqvist

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  17. Ablation of atrial fibrillation and dementia risk reduction during long-term follow-up: a nationwide population-based study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Leif FribergDepartment of Clinical Sciences, Karolinska Institutet at Danderyd University Hospital, Storskogsvägen 5, Stockholm, Sweden.
Tommy AnderssonDepartment of Clinical Sciences, Karolinska Institutet at Danderyd University Hospital, Storskogsvägen 5, Stockholm, Sweden.
Mårten RosenqvistDepartment of Clinical Sciences, Karolinska Institutet at Danderyd University Hospital, Storskogsvägen 5, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo investigate if patients with atrial fibrillation (AF) without clear indication for oral anticoagulant (OAC) due to perceived low stroke risk may benefit from OAC treatment when also dementia and intracerebral bleeding risks are considered. METHODS AND

resultsRetrospective study of cross-matched national registries of all individuals in Sweden with a hospital diagnosis of AF between 2006 and 2014 (n = 456 960). Exclusion was made of patients with a baseline CHA2DS2-VASc score >1, not counting female sex, and of patients with previous diagnosis of dementia or intracranial bleeding. After exclusions, 91 254 patients remained in the study of whom 43% used OAC at baseline. Propensity score matching and falsification endpoints were used. Treatment with OAC was associated with lower risk of dementia after adjustment for death as a competing risk [subhazard ratio (sHR) 0.62 with 95% confidence interval (CI) 0.48-0.81]. Regarding the composite brain protection endpoint, OAC treatment was associated with an overall 12% lower risk (sHR 0.88, CI 0.72-1.00). This apparent benefit was restricted to patients aged >65 years, whereas OAC treatment of patients <60 years of age without risk factors appeared to do more harm than good.

conclusionLow-risk AF patients who take OAC have lower risk of dementia than those who do not use OAC. Patients age >65 years appear to benefit from OAC treatment irrespective of stroke risk score.

Indexed as

Administration, OralAnticoagulantsAtrial FibrillationDementiaFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentStrokeAnticoagulantsAtrial fibrillationDementiaIntracerebral bleedingOral anticoagulationStroke

Identifiers

PMID31095295
PMCPMC6642728

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Registered trials

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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.