Anticoagulation to prevent ischemic stroke and neurocognitive impairment in atrial fibrillation: the BRAIN-AF randomized clinical trial.

ABSTRACT: Individuals with atrial fibrillation (AF) are at increased risk of stroke, cognitive impairment and dementia. Observational studies suggest that anticoagulation may reduce the risk of cognitive decline in patients with AF and elevated thromboembolic risk, implicating subclinical cerebral emboli as a potential mechanistic link. Whether anticoagulation prevents cognitive deterioration in patients with AF at low risk of stroke remains uncertain. Here we conducted a multicenter, double-blind, placebo-controlled trial in which participants with AF and low thromboembolic risk (CHA₂DS₂-VASc scores of 0 or 1, excluding female sex) were randomized 1:1 to receive rivaroxaban 15 mg daily or placebo. The primary outcome was a composite of cognitive decline (≥2-point drop in Montr

SUBMITTER: Rivard L 

PROVIDER: S-EPMC12823401 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature