{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:44:29Z","timestamp":1786236269132,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose:<\/jats:title>\n            <jats:p>Atrial fibrillation is a risk factor for dementia, and oral anticoagulant use is associated with a decreased risk of dementia in patients with atrial fibrillation. We aimed to investigate whether the risk of dementia would be different between patients treated with direct oral anticoagulants (DOACs) compared with those with warfarin.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Using the Korean nationwide claims database from January 2014 to December 2017, we identified oral anticoagulant\u2013naive nonvalvular atrial fibrillation patients aged \u226540 years. For the comparisons, warfarin and DOAC groups were balanced using the inverse probability of treatment weighting method. The primary outcome was incident dementia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Among 72\u2009846 of total study patients, 25\u2009948 were treated with warfarin, and 46\u2009898 were treated with DOAC (17\u2009193 with rivaroxaban, 9882 with dabigatran, 11\u2009992 with apixaban, and 7831 with edoxaban). During mean 1.3\u00b11.1 years of follow-up, crude incidence of dementia was 4.87 per 100 person-years (1.20 per 100 person-years for vascular dementia and 3.30 per 100 person-years for Alzheimer dementia). Compared with warfarin, DOAC showed a comparable risks of dementia, vascular dementia, and Alzheimer dementia. In subgroup analyses, DOAC was associated with a lower risk of dementia than warfarin, particularly in patients aged 65 to 74 years (hazard ratio, 0.815 [95% CI, 0.709\u20130.936]) and in patients with prior stroke (hazard ratio, 0.891 [95% CI, 0.820\u20130.968]). When comparing individual DOACs with warfarin, edoxaban was associated with a lower risk of dementia (hazard ratio, 0.830 [95% CI, 0.740\u20130.931]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In this large Asian population with atrial fibrillation, DOAC showed a comparable risk of dementia with warfarin overall. DOACs appeared more beneficial than warfarin, in those aged 65 to 74 years or with a history of stroke. For specific DOACs, only edoxaban was associated with a lower risk of dementia than warfarin.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.120.033338","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T09:00:17Z","timestamp":1631178017000},"page":"3459-3468","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Comparing Warfarin and 4 Direct Oral Anticoagulants for the Risk of Dementia in Patients With Atrial Fibrillation"],"prefix":"10.1161","volume":"52","author":[{"given":"So-Ryoung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.-R.L., E.-K.C., S.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-6372","authenticated-orcid":true,"given":"Eue-Keun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.-R.L., E.-K.C., S.O.)."},{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)."},{"name":"Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0612-2562","authenticated-orcid":true,"given":"Sang-Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (S.-H.P., J.-H.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Hyung","family":"Jung","sequence":"additional","affiliation":[{"name":"Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (S.-H.P., J.-H.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Do","family":"Han","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom (K.-D.H., G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2504-9615","authenticated-orcid":true,"given":"Seil","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.-R.L., E.-K.C., S.O.)."},{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)."},{"name":"Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":true,"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)."},{"name":"Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)."},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom (K.-D.H., G.Y.H.L.)."},{"name":"Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.02.039"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.10.001"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.12.004"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx208"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-5-201303050-00007"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.074"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30196-5"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx579"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz386"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2018.10.025"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.01.007"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036046"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005894"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62343-0"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz304"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011358"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009561"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.020232"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.04.108"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.025536"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2020.0171"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw253"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-018-0442-3"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5984"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6607"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.060"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118333"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61194-4"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-58665-5"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8122228"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008650"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.08.007"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.02.014"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.09.1087"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113665"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2019.60.3.277"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.07.022"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.120.033338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:50:58Z","timestamp":1715611858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.120.033338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":39,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1161\/STROKEAHA.120.033338"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.120.033338","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]},"assertion":[{"value":"2020-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}