Latest study reveals that overtreatment or long-term use of anti-clotting drugs along with antiplatelet therapy may elevate the risks of dementia in patients.
Dr. T. Jared Bunch, director of electrophysiology at the Intermountain Heart Institute in Murray, Utah, who is also the lead author of the study, reveals that the combination of anti-clotting drugs with antiplatelet therapy is often recommended to avert strokes and heart attacks in patients who are suffering from peripheral vascular or coronary artery disease. However, long-term exposure to anti-clotting drug like warfarin may give rise to bleeding risks significantly, if not controlled properly.
The dual treatment may also cause some sort of micro bleeds in the brain, which may not show symptoms immediately, but bleeding may accumulate gradually and raise dementia risks in patients.
Dr. Bunch also highlights that vascular dementia is the second most common type of dementia, which is a result of brain damage due to blocked or reduced blood flow in the vessels that leads to the brain.
The researchers conducted a study on more than 1,000 patients suffering from atrial fibrillation (AF), a common type of heart disease, for up to 10 years. During this period, the patients were treated with the combination of antiplatelet and anti-clotting drugs. No patient had any previous dementia or stroke history.
The study found that patients who suffered slow and gradual blood clotting - International Normalized Ratio (INR) of 3 or more, on 25 percent of monitoring test were twice more likely to be affected with dementia when compared to patients whose tests reflected that they received extended treatment for less than 10 percent of the recommended time.
Dr. Bunch highlighted at previous study which revealed that AF patients who took only warfarin were at higher risk of developing dementia either from very slow or very fast bleeding. The authors of the study suggest that these results conclude that brain injury, either from small or high clots and bleed, was significant in an AF patient developing dementia.
"Even at skilled centers, it's very common to have INR outside the ideal range up to 40 percent of the time, and over the years there may be an accumulative negative impact on cognitive ability," says Dr. Bunch.
The study was presented at the American Heart Association's Scientific Sessions 2014.
