{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:08:11Z","timestamp":1785409691277,"version":"3.56.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"Ministry of Science and Technology","award":["MOST 107\u20132314-B-075\u2013062-MY3"],"award-info":[{"award-number":["MOST 107\u20132314-B-075\u2013062-MY3"]}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"crossref","award":["V108B-015"],"award-info":[{"award-number":["V108B-015"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"crossref","award":["V108B-027"],"award-info":[{"award-number":["V108B-027"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"crossref","award":["V108C-090"],"award-info":[{"award-number":["V108C-090"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"crossref","award":["V109C-042"],"award-info":[{"award-number":["V109C-042"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"crossref","award":["V109C-186"],"award-info":[{"award-number":["V109C-186"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Research Foundation of Cardiovascular Medicine, Taipei, Taiwan"},{"name":"Szu-Yuan Research Foundation of Internal Medicine, Taipei, Taiwan"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>\n            Background\u2003Dementia and atrial fibrillation (AF) have many shared risk factors. Besides, patients with dementia are under-represented in randomized trials, and even if AF is present, oral anticoagulants (OACs) are not prescribed frequently. This study aimed to report the incidence of newly diagnosed AF in dementia patients, and the impacts of use of vitamin K antagonist (VKA; e.g., warfarin) and non-VKA OAC (NOACs) on stroke and bleeding outcomes.<\/jats:p><jats:p>\n            Methods\u2003Our study utilized the Taiwan National Health Insurance Research Database. A total of 554,074 patients with dementia were compared with 554,074 age- and sex-matched patients without dementia regarding the risk of incident AF. Among patients with dementia who experienced incident AF, the risks of clinical events of patients treated with warfarin or NOACs were compared with those without OACs (reference group).<\/jats:p><jats:p>\n            Results\u2003The risk of incident AF was greater for patients with dementia compared with those without (adjusted hazard ratio [aHR]: 1.054; 95% confidence interval [CI]: 1.040\u20131.068 for all types of dementia, aHR: 1.035; 95% CI: 1.020\u20131.051 for presenile\/senile dementia, and aHR: 1.125; 95% CI: 1.091\u20131.159 for vascular dementia). Among patients with dementia and experienced incident AF, warfarin use was associated with a higher risk of ischemic stroke (aHR: 1.290; 95% CI: 1.156\u20131.440), intracranial hemorrhage (ICH; aHR: 1.678; 95% CI: 1.346\u20132.090), and major bleeding (aHR: 1.192; 95% CI: 1.073\u20131.323) compared with non-OACs. NOAC use was associated with a lower risk of ischemic stroke (aHR: 0.421; 95% CI: 0.352\u20130.503) and composite risk of ischemic stroke or major bleeding (aHR: 0.544; 95% CI: 0.487\u20130.608) compared with non-OACs. These results were consistent among the patients after the propensity matching.<\/jats:p><jats:p>\n            Conclusion\u2003In this large nationwide cohort, the risk of newly diagnosed AF was higher in patients with dementia (all dementia, presenile\/senile dementia, and vascular dementia) compared with those without dementia. For patients with dementia who experienced incident AF, NOAC use was associated with a better clinical outcome compared with non-OAC. Patients with dementia require a holistic approach to their care and management, including the use of NOACs to reduce the risks of clinical events.<\/jats:p>","DOI":"10.1055\/a-2184-7506","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T22:32:00Z","timestamp":1696113120000},"page":"253-262","source":"Crossref","is-referenced-by-count":9,"title":["Risk of Incident Atrial Fibrillation and Subsequent Use of Oral Anticoagulants in Patients with Dementia"],"prefix":"10.1055","volume":"124","author":[{"given":"Chuan-Tsai","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hsin","family":"Chan","sequence":"additional","affiliation":[{"name":"The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"},{"name":"Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo-Nan","family":"Liao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzeng-Ji","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom and Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ann","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan"},{"name":"Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.cjca.2022.10.013","article-title":"Mechanisms and clinical manifestations of cognitive decline in atrial fibrillation patients: potential implications for preventing dementia","volume":"39","author":"S Blum","year":"2023","journal-title":"Can J Cardiol"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1111\/jgs.14421","article-title":"Causes of death according to death certificates in individuals with dementia: a cohort from the Swedish Dementia Registry","volume":"64","author":"S Garcia-Ptacek","year":"2016","journal-title":"J Am Geriatr Soc"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/jamacardio.2015.0345","article-title":"Incidence and determinants of traumatic intracranial bleeding among older veterans receiving warfarin for atrial fibrillation","volume":"1","author":"J A Dodson","year":"2016","journal-title":"JAMA Cardiol"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1161\/CIRCULATIONAHA.121.055018","article-title":"Atrial fibrillation and dementia: a report from the AF-SCREEN International Collaboration","volume":"145","author":"L Rivard","year":"2022","journal-title":"Circulation"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1186\/s12916-022-02563-2","article-title":"Effects of dabigatran versus warfarin on 2-year cognitive outcomes in old patients with atrial fibrillation: results from the GIRAF randomized clinical trial","volume":"20","author":"B Caramelli","year":"2022","journal-title":"BMC Med"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"e011358","DOI":"10.1161\/JAHA.118.011358","article-title":"Nonvitamin K antagonist oral anticoagulants versus warfarin in atrial fibrillation patients and risk of dementia: a nationwide propensity-weighted cohort study","volume":"8","author":"M S\u00f8gaard","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.mayocp.2020.08.042","article-title":"Non-vitamin K antagonist oral anticoagulants in elderly (\u226585 years) patients with newly diagnosed atrial fibrillation: changing clinical practice and outcomes for stroke prevention in a nationwide cohort study","volume":"96","author":"W H Cheng","year":"2021","journal-title":"Mayo Clin Proc"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.hrthm.2021.02.018","article-title":"Oral anticoagulants in extremely-high-risk, very elderly (>90 years) patients with atrial fibrillation","volume":"18","author":"T F Chao","year":"2021","journal-title":"Heart Rhythm"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s00392-021-01816-z","article-title":"Continuation or discontinuation of oral anticoagulants after HAS-BLED scores increase in patients with atrial fibrillation","volume":"111","author":"T F Chao","year":"2022","journal-title":"Clin Res Cardiol"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1093\/ehjqcco\/qcab050","article-title":"Should oral anticoagulants still be prescribed to patients with atrial fibrillation with a single stroke risk factor but at high bleeding risk? A nationwide cohort study","volume":"8","author":"T F Chao","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"805399","DOI":"10.3389\/fcvm.2021.805399","article-title":"Modified Taiwan Atrial Fibrillation Score for the prediction of incident atrial fibrillation","volume":"8","author":"J N Liao","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/ehjqcco\/qcab076","article-title":"Stroke prevention with direct oral anticoagulants in high-risk elderly atrial fibrillation patients at increased bleeding risk","volume":"8","author":"T F Chao","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"issue":"17","key":"ref13","doi-asserted-by":"crossref","first-page":"e020194","DOI":"10.1161\/JAHA.120.020194","article-title":"Clinical risk score for the prediction of incident atrial fibrillation: derivation in 7 220 654 taiwan patients with 438 930 incident atrial fibrillations during a 16-year follow-up","volume":"10","author":"T F Chao","year":"2021","journal-title":"J Am Heart Assoc"},{"issue":"11","key":"ref14","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1055\/a-1807-0336","article-title":"Early rhythm control and the risks of ischemic stroke, heart failure, mortality, and adverse events when performed early (<3 months): a nationwide cohort study of newly diagnosed patients with atrial fibrillation","volume":"122","author":"T F Chao","year":"2022","journal-title":"Thromb Haemost"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ijcard.2017.11.025","article-title":"Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: attention to modifiable bleeding risk factors or use of a bleeding risk stratification score? A nationwide cohort study","volume":"254","author":"T F Chao","year":"2018","journal-title":"Int J Cardiol"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"e206424","DOI":"10.1001\/jamanetworkopen.2020.6424","article-title":"Association of ischemic stroke, major bleeding, and other adverse events with warfarin use vs non-vitamin K antagonist oral anticoagulant use in patients with atrial fibrillation with a history of intracranial hemorrhage","volume":"3","author":"C T Tsai","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1002\/pds.2087","article-title":"Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan","volume":"20","author":"C L Cheng","year":"2011","journal-title":"Pharmacoepidemiol Drug 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Dietzel","year":"2018","journal-title":"Europace"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1093\/europace\/euz336","article-title":"Improved brain perfusion after electrical cardioversion of atrial fibrillation","volume":"22","author":"M Gardarsdottir","year":"2020","journal-title":"Europace"},{"issue":"28","key":"ref22","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1093\/eurheartj\/ehz386","article-title":"Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a population-based cohort","volume":"40","author":"D Kim","year":"2019","journal-title":"Eur Heart J"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s11239-022-02722-5","article-title":"Use of SAMe-TT(2)R(2) in a racially diverse anticoagulation clinic: prediction of optimal anticoagulation","volume":"55","author":"K Wang","year":"2023","journal-title":"J Thromb 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Schnabel","year":"2023","journal-title":"Europace"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1055\/a-1515-9630","article-title":"Adherence to the \u2018Atrial Fibrillation Better Care\u2019 pathway in patients with atrial fibrillation: impact on clinical outcomes-a systematic review and meta-analysis of 285,000 patients","volume":"122","author":"G F Romiti","year":"2022","journal-title":"Thromb Haemost"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"G Hindricks","year":"2021","journal-title":"Eur Heart J"},{"issue":"10","key":"ref29","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1055\/s-0042-1750385","article-title":"Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism: executive summary of a European and Asia-Pacific Expert Consensus Paper","volume":"122","author":"D A Gorog","year":"2022","journal-title":"Thromb Haemost"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.atherosclerosis.2013.11.036","article-title":"Continuation of statin therapy and a decreased risk of atrial fibrillation\/flutter in patients with and without chronic kidney disease","volume":"232","author":"C H Chang","year":"2014","journal-title":"Atherosclerosis"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2184-7506.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:18:09Z","timestamp":1730801889000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2184-7506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,30]]},"references-count":30,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2024,2,23]]},"published-print":{"date-parts":[[2024,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2184-7506","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9,30]]},"published":{"date-parts":[[2023,9,30]]}}}