Madhavan M, et al. - This trial was undertaken in order to gauge the connection between time in therapeutic range (TTR) during warfarin therapy and the risk of dementia in individuals with incident atrial fibrillation (AF). As per the outcomes, warfarin therapy for AF exhibited a link with 20% reduction in the risk of dementia. It was determined that a rise in TTR on warfarin correlated with reduced risk of dementia. Reduced risk of dementia was noted alongside a reduction in time spent in the subtherapeutic and supratherapeutic international normalized ratio range. Data disclosed that effective anticoagulation could prevent the cognitive impairment in the study cohort.

Methods

• The scheme of this trial was an observational population-based study.
• Experts enrolled 2,800 nondemented patients with incident AF from January 1, 2000 to December 31, 2010.
• With the aid of Cox proportional hazards regression models, they scrutinized connection between incident dementia with warfarin therapy and TTR.

Results

• It was determined that the mean patient age was 71.2 years, wherein 53% were men (n=1495), and warfarin was prescribed to 50.5% (n=1414) within 90 days of AF diagnosis.
• The occurrence of incident dementia diagnosis was reported in 357 patients (12.8%) over a mean ± SD follow-up of 5.0±3.7 years.
• A link was disclosed between warfarin therapy with a reduced incidence of dementia (hazard ratio [HR], 0.80; 95% CI, 0.64-0.99), after adjusting for confounders.
• Nevertheless, only those in the 2 highest quartiles of TTR exhibited a tie-up with the lower risk of dementia.
• Findings shed light on the correlation between a 10% increase in TTR with a 10% reduction in time spent in the subtherapeutic (HR, 0.71; 95% CI, 0.64-0.79) and supratherapeutic (HR, 0.67; 95% CI, 0.57-0.79) ranges, with decreased risk of dementia.