Conference News Roundup—Heart Rhythm Society

Delayed Use of Blood Thinners for Atrial Fibrillation Increases Risk of Dementia

Dementia rates increase when anticoagulation treatment is delayed for patients with atrial fibrillation. A large-scale study included more than 76,000 patients with atrial fibrillation with no prior history of dementia who were treated with an antiplatelet or warfarin.

Researchers studied patients from the time of their atrial fibrillation diagnosis to actual start of an antiplatelet agent or anticoagulation therapy. Patients were then grouped into two categories: those who received immediate treatment (started less than 30 days after diagnosis) and those who received delayed treatment (started after one year).

Using the CHADS2 VASc score to predict stroke risks and identify those at highest risk of cognitive decline with a delay in therapy, researchers found that the risk of dementia in low-risk patients was 30% higher for those who received delayed treatment, and a significant 136% higher for high-risk patients.

Researchers also found that when the time period of delays was analyzed as a spectrum including less than 30 days, 31 days to one year, one to three years, and longer than three years, the risk of dementia increased as the delays in warfarin initiation increased.

“Our results reinforce the importance of starting anticoagulation treatment as early as possible after a patient is diagnosed with atrial fibrillation,” said Jared Bunch, MD, Director of Heart Rhythm Research at the Intermountain Medical Center Heart Institute in Salt Lake City.