Overuse of anticoagulants raises dementia risk in AF patients

Long-term overtreatment with anticoagulants combined with antiplatelet therapy to prevent stroke could increase the risk of dementia in patients with AF, researchers have found.

Dementia: risk from overuse of anticoagulants (Photo: JH Lancy)

US researchers found that long-term use of warfarin, if not well controlled, can significantly increase a patient’s bleeding risk and produce micro-bleeds which can, over time, raise the risk of dementia.

The research, presented at the American Heart Association Scientific Sessions 2014, found that patients with abnormally slow blood clotting times, considered a sign of receiving too much medication, on a quarter or more of their monitoring tests were more than twice as likely to be diagnosed with dementia.

The increase is higher than found in previous studies by the same team of researchers, which looked at patients treated only with warfarin.

The researchers suggested that patients taking warfarin and an antiplatelet drug such as aspirin should ask their doctor if both drugs were necessary.

16,000 strokes prevented

Earlier this month, NHS Improving Quality suggested that 16,000 strokes could have been prevented in England if eligible AF patients were treated with anticoagulants.

It concluded that 3,200 of these strokes would have been fatal, and that if all eligible patients were given warfarin it would have saved the NHS £124m a year.

Last month, clinical geneticist Professor Sir John Burn told the RCGP annual conference that testing patients for genetic sensitivity to warfarin could improve outcomes and save money.

Professor Burn, from Newcastle University, said the required type of genetic testing could be done for £20 in 20 minutes, and he said his team had begun to trial point-of-care tasting and genotype-led dosage adjustment of warfarin in Newcastle.

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