探索抗凝血,认知障碍和心房的痴呆症之间的联系:一个系统性审查
Abhimanyu Agarwal1, Mohamed A Mostafa1, Muhammad Imtiaz Ahmad2
1Epidemiological Cardiology Research Center, Section on Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA.
Journal of clinical medicine
|April 27, 2024
概括
口服抗凝剂可能有助于预防心房患者的认知障碍和痴呆症. 需要进一步的研究,包括随机对照试验,以证实这些发现有效的血栓预防.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 使用口服抗凝剂 (OAC) 的心房动 (AF) 患者的认知障碍和痴呆风险需要进一步调查.
- 目前对OAC对AF认知健康的影响的研究是有限的.
- 本系统性审查解决了有关OAC和AF认知衰退的知识差距.
研究的目的:
- 系统地审查和综合有关口服抗凝剂使用与心房动患者认知障碍或痴呆症相关的证据.
- 评估不同OACs,包括直接口服抗凝剂 (DOACs) 和维生素K对抗剂 (VKAs) 对认知结果的影响.
- 确定血栓预防治疗在缓解AF患者认知衰退方面的潜在好处.
主要方法:
- 在SCOPUS和PubMed的系统文献搜索中进行英语语言研究.
- 纳入标准侧重于对AF患者的OAC和认知障碍/痴呆症的原始研究,不包括癌症或精神疾病等特定疾病.
- 从22项涉及超过60万名患者的确定的研究中提取和合成数据.
主要成果:
- 十三项研究 (n=597,744) 表明,用血栓预防治疗减少了认知障碍/痴呆症.
- 十项研究 (n=284,636) 显示,使用直接口服抗凝剂 (DOAC) 的认知障碍发生率较低.
- 三项研究 (n=61,991) 表明,与维生素K对抗剂 (VKA) 相比,DOAC与较低的痴呆风险有关,更好的VKA控制与较低的痴呆发病率有关.
结论:
- 口服抗凝剂显示出在心房患者中预防认知障碍和痴呆的潜力.
- 观测数据表明它具有保护作用,特别是在DOACs.
- 进一步的随机对照试验至关重要,以确定抗凝剂在保持认知功能的有效性.
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