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Cognitive screening for cardiovascular risk stratification in stable coronary artery disease: a prospective cohort

Zehao Zhao1, Yaodong Ding1, Yong Zeng1,2,3

  • 1Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Archives of Medical Science : AMS
|August 1, 2026
PubMed

Insights

Cognitive impairment in stable coronary artery disease (CAD) patients predicts major adverse cardiovascular events (MACE). This finding highlights the importance of assessing cognitive function for cardiovascular risk stratification.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Cognitive impairment is common in coronary artery disease (CAD) patients.
  • The prognostic value of cognitive impairment in stable CAD is not well-established.

Purpose of the Study:

  • To investigate the association between baseline cognitive function and major adverse cardiovascular events (MACE) in stable CAD patients.
  • To determine if cognitive impairment is an independent predictor of MACE in this population.

Main Methods:

  • Prospective cohort study of 6,130 stable CAD patients.
  • Cognitive function assessed using Montreal Cognitive Assessment (MoCA).
  • Primary outcome: MACE (all-cause death, nonfatal myocardial infarction, nonfatal stroke). Secondary outcome: unplanned revascularization. Analyzed using Kaplan-Meier and Cox regression.

Main Results:

  • Patients with cognitive impairment had a significantly higher incidence of MACE (log-rank p = 0.001).
  • Cognitive impairment remained an independent predictor of MACE after multivariable adjustment (HR = 1.58, p = 0.026).
  • No significant difference in unplanned revascularization incidence was observed.

Conclusions:

  • Baseline cognitive impairment is an independent predictor of MACE in stable CAD patients.
  • Cognitive function assessment may aid in cardiovascular risk stratification for CAD patients.
Abstract

Keywords:
cognition impairmentcognitive screeningcoronary artery diseasemajor adverse cardiovascular eventsrisk stratification

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