Affiliations: [a] Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| [b] Department of and Master’s Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| [c] Department of Neurology, Kaohsiung Municipal Siao-Gang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| [d] Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| [e] Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
Correspondence:
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Correspondence to: Yuan-Han Yang, MD, PhD, Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, No. 68, Jhonghua 3rd Road, Cianjin District, Kaohsiung City 80145, Taiwan. Tel.: +886 7 2911101; Fax: + 886 7 2911590; E-mail: endless@kmu.edu.tw.
Abstract: Background:Patients with atrial fibrillation (AF) carry higher risks of cognitive consequences and psychological burden. An optimal anticoagulant therapy would be expected to better preserve neuropsychological function in addition to effective prevention of stroke and systemic thromboembolism. Objective:The aim of this review is to explore the effects of the non-vitamin K antagonist oral anticoagulant (NOAC) dabigatran, a direct thrombin inhibitor, on cognitive and psychological function as well as dementia pathogenesis. Methods:We performed a comprehensive search of PubMed/Medline for all types of relevant articles using a combination of dabigatran and associated keywords updated to August 31, 2021. All titles and abstracts were screened for eligibility, and potentially relevant papers were collected for inclusion. Results:The pooled results demonstrated neutral to positive impacts of dabigatran on cognitive and psychological outcomes, including laboratory results in animal models of Alzheimer’s disease, and reduced incidences of anxiety/depression and dementia for AF patients. Dabigatran also exhibited better therapeutic profiles than warfarin in preclinical and observational research. Conclusion:Given limited strength of evidence from heterogeneous studies, our review proposed modest beneficial effects of dabigatran on neuropsychological function. Further clinical trials are warranted to affirm the pleiotropic protective effects of NOACs on dementia treatment.
Keywords: Anticoagulant, atrial fibrillation, cognitive, dabigatran, dementia, psychological function
