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Direct oral anticoagulants vs vitamin K antagonist on dementia risk in atrial fibrillation: systematic review with meta-analysis

2023Journal article Open access
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dc.contributor.authorBranco, Diogo R
dc.contributor.authorAlves, Mariana
dc.contributor.authorSeveriano E Sousa, Catarina
dc.contributor.authorCosta, João
dc.contributor.authorFerreira, Joaquim J
dc.contributor.authorCaldeira, Daniel
dc.date.accessioned2023-07-20T13:40:31Z
dc.date.available2023-07-20T13:40:31Z
dc.date.issued2023
dc.description© The Author(s) 2023. This article is licensed under a Creative Commons Attri- bution 4.0 International License, which permits use, sharing, adapta- tion, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/pt_PT
dc.description.abstractOral anticoagulation significantly reduces the incidence of dementia in atrial fibrillation patients. However, this protective effect has not been compared between Direct Oral Anticoagulants (DOAC) and Vitamin K antagonists' anticoagulants (VKA). We conducted an electronic search for potentially eligible studies through the bibliographic databases MEDLINE, CENTRAL, ClinicalTrials.gov, EMBASE and Web of Science. The outcome of interest was dementia. Random-effects meta-analysis was performed. Nine observational studies were included and 1,175,609 atrial fibrillation patients were enrolled. DOAC therapy was associated with a significant reduction when compared with patients under VKA therapy (hazard ratio 0.89; 95% confidence interval 0.80-0.99). The grade of confidence of our results was very low due to the risk of bias. DOAC therapy is associated with a significant decrease in the risk of dementia when compared with VKA therapy. However, the low certainty of the evidence along with the paucityof clinical trials dedicated to answering this important question underscores a need for global clinical research initiatives.pt_PT
dc.description.sponsorshipOpen access funding provided by FCT|FCCN (b-on).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Thromb Thrombolysis. 2023 Jul 5pt_PT
dc.identifier.doi10.1007/s11239-023-02843-5pt_PT
dc.identifier.eissn1573-742X
dc.identifier.issn0929-5305
dc.identifier.urihttp://hdl.handle.net/10451/58693
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Naturept_PT
dc.relation.publisherversionhttps://www.springer.com/journal/11239pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAnticoagulationpt_PT
dc.subjectAtrial fibrillationpt_PT
dc.subjectDOACpt_PT
dc.subjectDementiapt_PT
dc.subjectVKApt_PT
dc.titleDirect oral anticoagulants vs vitamin K antagonist on dementia risk in atrial fibrillation: systematic review with meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleJournal of Thrombosis and Thrombolysispt_PT
person.familyNameBranco
person.familyNameAlves
person.familyNameCosta
person.familyNameFerreira
person.familyNameCaldeira
person.givenNameDiogo
person.givenNameMariana
person.givenNameJoão
person.givenNameJoaquim J
person.givenNameDaniel
person.identifier1153684
person.identifier480560
person.identifier1624753
person.identifier.ciencia-id0718-09A9-D4EA
person.identifier.ciencia-id7D15-5CD6-6159
person.identifier.ciencia-idAA19-EC35-8D01
person.identifier.orcid0000-0003-1191-9138
person.identifier.orcid0000-0002-1369-8423
person.identifier.orcid0000-0002-5831-4921
person.identifier.orcid0000-0003-3950-5113
person.identifier.orcid0000-0002-2520-5673
person.identifier.ridO-3034-2016
person.identifier.scopus-author-id56591535500
person.identifier.scopus-author-id55499748300
person.identifier.scopus-author-id7403252466
person.identifier.scopus-author-id36623384200
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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