Comorbidities and mortalities 983 pendent predictor for bleeding risk was the presence of a labile INR (standardized HR 7.0; 95% CI, 0.9, 53.3). K-M survival function for bleeding is shown. Conclusions: In conclusion, patients with cancer and atrial fibrillation represent a high-risk population. VKA remains as the most widely used anticoagulant in this context despite high variations in the INR. A labile INR should trigger reconsidering VKA usage, as it is strongly associated with bleeding

more »

... s. Background: Atrial fibrillation (AF) has been suggested as a risk factor for dementia. AF-related emboli might be a modifiable contributor to progressive cognitive decline. Purpose: To estimate the occurrence of new onset cognitive impairment in a population with incident non-valvular AF, and to explore the potential modifying role of oral anticoagulation. Methods: We performed a cohort study of 11,343 patients (mean age 67.9±11.2 years, 60.4% male) with incident non-valvular AF and 38,256 age-and gendermatched controls without AF identified from all patients at risk for a first diagnosis of dementia in the UK Clinical Practice Research Datalink (CPRD) (linked to hospital discharges) between 2008 and 2014. A diagnosis of dementia was defined from Read medical codes and ICD-10 codes. Dementia cases were required to have no diagnosis of Creutzfeld-Jakob, Huntington's, Parkinson's or Pick's disease in the 182 days after the dementia diagnosis. Hazard ratios (HR) for dementia diagnosis were estimated and adjusted for BMI, smoking, socioeconomic status, CHA2DS2-VASc risk score and components of the Charlson comorbidity index. Results: Mean follow-up was 20.3±0.1 months. During 83,427 person-years of follow-up, there were 513 cases of newly diagnosed dementia (AF 1.6% vs. controls 0.9%). Table 1 provides the HR for new-onset dementia in incident AF patients (both for the subset treated with oral anticoagulants as well as those without anticoagulation) versus those without AF. Exclusion of patients taking antidepressants before the dementia diagnosis did not influence these results.