ObjectiveTo investigate the prophylactic effects of novel anticoagulants on stroke and cognitive impairment in elderly patients with paroxysmal atrial fibrillation.

MethodsA total of 646 elderly patients with paroxysmal atrial fibrillation were divided into the coagulation factor Xa inhibitor group(n=318, group A), coagulation factor Ⅱ ainhibitor group(n=145, group B) and warfarin group(n=183, group C) according to the used anticoagulant.In three groups, the incidence of stroke, cognitive impairment and other events were prospectively analyzed, and the cognitive function was evaluated using the mini-mental status examination(MMSE).

ResultsThe differences of the incidence rates of stroke, bleeding and mortality among three groups were not statistically significant during 24 months of following-up(P>0.05).The differences of the incidence rates of mild cognitive impairment and MMSE scores among three groups were not statistically significant at baseline and after 6 months and 12 months of anticoagulant therapy(P>0.05).The retest results after 24 months of anticoagulant therapy showed that the incidence rates of mild and above cognitive impairment, and MMSE scores in A, B and C group were (14.7%, 15.7% and 24.4%) and(27.45±3.28), (27.26±3.14) and (26.13±3.54), respectively.The differences in the incidence rates of cognitive impairment and MMSE score among three groups were statistically significant(P < 0.05).

ConclusionThe novel anticoagulant have good efficacy and safety in atrial fibrillation-related stroke, and may play a positive role in the prevention of cognitive impairment in patients with atrial fibrillation.