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: Atotal of5221 patients over 20 years ofagewho had a history ofAF as noted in ambulatoryand 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 of5.90 土 3.39 years, 135 patients ofgroup 1 (3.1%) and 25 ofgroup 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 duringthe follow-up period (log rank p = 0.91). Cox-regression analysis also showed that usage ofACEI 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 ofdementia in patients with AF.