ACEI and ARB did not reduce the incidence of dementia in patients with atrial fibrillation: A nationwide cohort study

Min Tsun Liao, Lian Yu Lin, Yao Hsu Yang, Tin Tse Lin, Jiunn Lee Lin, Pau Chung Chen, Chia Ti Tsai

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Atrial fibrillation (AF) is associated with increased risk of thromboembolism, and is also a predisposing factor to dementia. Our investigation was a retrospective observational study to evaluate whether the usage of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) could reduce the incidence of dementia in patients with AF. Methods: A total of 5221 patients over 20 years of age who had a history of AF as noted in ambulatory and inpatient claims data were enrolled from the National Health Insurance Research Database of Taiwan in 1997 and 1998. Patients with ACEI or ARB were designated as group 1 (4343 patients), and patients without ACEI or ARB were designated as group 2 (878 patients). Results: During a follow-up of 5.90-3.39 years, 135 patients of group 1 (3.1%) and 25 of group 2 (2.8%) developed new-onset dementia. Group 1 and group 2 had similar proportions of new-onset dementia (p = 0.75). The Kaplan-Meier curve demonstrated that patients with ACEI or ARB were not associated with a lower incidence of dementia during the follow-up period (log rank p = 0.91). Cox-regression analysis also showed that usage of ACEI or ARB was not associated with a lower risk of new-onset dementia after adjustment for gender and comorbidities. (Hazard ratio = 0.942, 95% confidence interval 0.589-1.506, and p = 0.80). Conclusions: ACEI or ARB may be ineffective in reducing the incidence of dementia in patients with AF.

Original languageEnglish
Pages (from-to)323-327
Number of pages5
JournalActa Cardiologica Sinica
Volume29
Issue number4
Publication statusPublished - Jul 1 2013
Externally publishedYes

Fingerprint

Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Atrial Fibrillation
Dementia
Cohort Studies
Incidence
Thromboembolism
National Health Programs
Taiwan
Causality
Observational Studies
Comorbidity
Inpatients
Retrospective Studies
Regression Analysis
Databases
Confidence Intervals

Keywords

  • Angiotensin II receptor blocker
  • Angiotensin-converting-enzyme inhibitor
  • Atrial fibrillation
  • Dementia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Liao, M. T., Lin, L. Y., Yang, Y. H., Lin, T. T., Lin, J. L., Chen, P. C., & Tsai, C. T. (2013). ACEI and ARB did not reduce the incidence of dementia in patients with atrial fibrillation: A nationwide cohort study. Acta Cardiologica Sinica, 29(4), 323-327.

ACEI and ARB did not reduce the incidence of dementia in patients with atrial fibrillation : A nationwide cohort study. / Liao, Min Tsun; Lin, Lian Yu; Yang, Yao Hsu; Lin, Tin Tse; Lin, Jiunn Lee; Chen, Pau Chung; Tsai, Chia Ti.

In: Acta Cardiologica Sinica, Vol. 29, No. 4, 01.07.2013, p. 323-327.

Research output: Contribution to journalArticle

Liao, Min Tsun ; Lin, Lian Yu ; Yang, Yao Hsu ; Lin, Tin Tse ; Lin, Jiunn Lee ; Chen, Pau Chung ; Tsai, Chia Ti. / ACEI and ARB did not reduce the incidence of dementia in patients with atrial fibrillation : A nationwide cohort study. In: Acta Cardiologica Sinica. 2013 ; Vol. 29, No. 4. pp. 323-327.
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abstract = "Purpose: Atrial fibrillation (AF) is associated with increased risk of thromboembolism, and is also a predisposing factor to dementia. Our investigation was a retrospective observational study to evaluate whether the usage of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) could reduce the incidence of dementia in patients with AF. Methods: A total of 5221 patients over 20 years of age who had a history of AF as noted in ambulatory and inpatient claims data were enrolled from the National Health Insurance Research Database of Taiwan in 1997 and 1998. Patients with ACEI or ARB were designated as group 1 (4343 patients), and patients without ACEI or ARB were designated as group 2 (878 patients). Results: During a follow-up of 5.90-3.39 years, 135 patients of group 1 (3.1{\%}) and 25 of group 2 (2.8{\%}) developed new-onset dementia. Group 1 and group 2 had similar proportions of new-onset dementia (p = 0.75). The Kaplan-Meier curve demonstrated that patients with ACEI or ARB were not associated with a lower incidence of dementia during the follow-up period (log rank p = 0.91). Cox-regression analysis also showed that usage of ACEI or ARB was not associated with a lower risk of new-onset dementia after adjustment for gender and comorbidities. (Hazard ratio = 0.942, 95{\%} confidence interval 0.589-1.506, and p = 0.80). Conclusions: ACEI or ARB may be ineffective in reducing the incidence of dementia in patients with AF.",
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AU - Lin, Lian Yu

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AU - Lin, Tin Tse

AU - Lin, Jiunn Lee

AU - Chen, Pau Chung

AU - Tsai, Chia Ti

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AB - Purpose: Atrial fibrillation (AF) is associated with increased risk of thromboembolism, and is also a predisposing factor to dementia. Our investigation was a retrospective observational study to evaluate whether the usage of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) could reduce the incidence of dementia in patients with AF. Methods: A total of 5221 patients over 20 years of age who had a history of AF as noted in ambulatory and inpatient claims data were enrolled from the National Health Insurance Research Database of Taiwan in 1997 and 1998. Patients with ACEI or ARB were designated as group 1 (4343 patients), and patients without ACEI or ARB were designated as group 2 (878 patients). Results: During a follow-up of 5.90-3.39 years, 135 patients of group 1 (3.1%) and 25 of group 2 (2.8%) developed new-onset dementia. Group 1 and group 2 had similar proportions of new-onset dementia (p = 0.75). The Kaplan-Meier curve demonstrated that patients with ACEI or ARB were not associated with a lower incidence of dementia during the follow-up period (log rank p = 0.91). Cox-regression analysis also showed that usage of ACEI or ARB was not associated with a lower risk of new-onset dementia after adjustment for gender and comorbidities. (Hazard ratio = 0.942, 95% confidence interval 0.589-1.506, and p = 0.80). Conclusions: ACEI or ARB may be ineffective in reducing the incidence of dementia in patients with AF.

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