• Long Shen, Chi Zhang, Zhi-Chun Gu, Hou-Wen Lin, Xiao-Yan Liu, and Jun Pu.
• Department of Cardiology Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
• Medicine (Baltimore). 2018 Aug 1; 97 (34): e12072e12072.

BackgroundThe association between use of non-vitamin K antagonist oral anticoagulants (NOACs) with cognitive impairment in atrial fibrillation (AF) remains unknown.MethodsAn electronic search of Medline, Embase, Cochrane Library databases and ClinicalTrials.gov Website will be performed for randomized controlled trials (RCTs) that reported cognitive impairment events and observational nationwide database studies that reported adjusted hazard ratio (HR) in AF patients with NOACs. The primacy outcome will be a composite of any forms of cognitive impairment. HRs and their 95% confidence intervals (95% CI) will be calculated by using fixed- and random-effects models. Subgroup analyses will be undertaken based on individual NOACs, study types and follow-up duration.ResultsThis study will provide evidence of the association between use of NOACs and risk of cognitive impairment in patients with AF by pooling the results of RCTs and real-world studies.ConclusionsThe results will bring about vigorous evidence in this topic and provide optimal anticoagulation strategy in AF patients at high risk of cognitive disorder.Ethics And DisseminationEthical approval is not applicable for this study.Prospero Registration NumberCRD42018103849.

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