Influence of cognitive impairment on cardiac mortality after percutaneous coronary intervention in very elderly
Tomoko Tomioka1, Ryokichi Takahashi1, Yosuke Ikumi1
1Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan.
Insights
Cognitive impairment (CI) significantly increases cardiac mortality in very elderly patients undergoing percutaneous coronary intervention (PCI). Social support, like living with a partner, also impacts cardiac outcomes after PCI.
Area of Science:
- Cardiology
- Geriatrics
- Neurology
Background:
- Cognitive impairment (CI) is linked to higher cardiac mortality in the very elderly.
- Percutaneous coronary intervention (PCI) is a strategy to reduce cardiac mortality in ischemic heart disease (IHD).
Purpose of the Study:
- To investigate the impact of cognitive impairment (CI) on cardiac mortality following percutaneous coronary intervention (PCI) in very elderly patients.
Main Methods:
- Retrospective analysis of 95 IHD patients over 80 years old who underwent PCI (2012-2014).
- Patients were screened for CI using the Mini-Mental State Examination.
- Comparison of cardiac mortality and adverse cardiac events between CI and non-CI groups over a 3-year follow-up.
Main Results:
- Cardiac mortality was significantly higher in the CI group (36%) versus the non-CI group (13%).
- CI was identified as an independent cardiac prognostic factor post-PCI.
- For patients with CI, living with a partner with CI independently predicted cardiac death within three years.
Conclusions:
- Cognitive impairment (CI) significantly worsens cardiac prognosis after PCI in very elderly individuals.
- Social factors, such as living situation, are crucial for improving patient outcomes post-PCI.
- Integrating social background assessment with medical management can enhance cardiac prognoses.
Background:
Cognitive impairment (CI) increases cardiac mortality among very elderly patients. Percutaneous coronary intervention (PCI) for ischemic heart disease (IHD) patients is considered a favorable strategy for decreasing cardiac mortality. Here, we investigated the influence of CI on cardiac mortality after PCI in very elderly patients.
Methods:
We performed a retrospective observational analysis of patients who received PCI between 2012 and 2014 at the South Miyagi Medical Center, Japan. IHD patients over 80 years old who underwent the Mini-Mental State Examination for CI screening during hospitalization and/or who had been diagnosed with CI were included. Participants were divided into CI and non-CI groups, and cardiac mortality and incidence of adverse cardiac events in a 3-year follow-up period were compared between groups. Statistical analyses were performed using the t-test, χ2 test, and multivariable Cox regression analysis, with major comorbid illness and conventional cardiac risk factors as confounders.
Results:
Of 565 patients, 95 were included (41 CI, 54 non-CI). Cardiac mortality during the follow-up period was significantly higher in the CI group (36%) compared with the non-CI group (13%) (OR = 4.3, 95% CI: 1.56-11.82, P < 0.05). CI was an independent cardiac prognostic factor after PCI and, for CI patients, living only with a CI partner was an independent predictor of cardiac death within three years.
Conclusions:
CI significantly affected cardiac prognosis after PCI in very elderly patients, particularly those living with a CI partner. To improve patients' prognoses, social background should be considered alongside conventional medical measures.
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