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Mayor riesgo de demencia vascular en sobrevivientes de infarto de miocardio

Jens Sundbøll^1,2, Erzsébet Horváth-Puhó³, Kasper Adelborg^3,2

¹Department of Clinical Epidemiology (J.S., E.H.-P., K.A., M.S., L.P., V.W.H., H.T.S.) jens.sundboll@clin.au.dk.

|October 14, 2017

Resumen

Los sobrevivientes de infarto de miocardio (IM) se enfrentan a un mayor riesgo de demencia vascular, especialmente si experimentan un accidente cerebrovascular. Sin embargo, el infarto de miocardio no aumenta el riesgo de enfermedad de Alzheimer u otras demencias.

Área de la Ciencia:

Medicina cardiovascular
Neurología
Epidemiología

Sus antecedentes:

Los sobrevivientes de infarto de miocardio (IM) pueden tener un mayor riesgo de demencia debido a factores de riesgo compartidos como la aterosclerosis y el accidente cerebrovascular post-IM.
La investigación de los riesgos específicos de demencia después del infarto de miocardio es crucial para comprender los resultados de salud a largo plazo.

Objetivo del estudio:

Examinar la asociación entre el infarto de miocardio (IM) y el subsiguiente riesgo de desarrollar demencia en sobrevivientes de 1 año.
Para diferenciar el riesgo de varios subtipos de demencia (enfermedad de Alzheimer, demencia vascular, otras demencias) después del infarto de miocardio.

Principales métodos:

Un estudio de cohorte basado en la población nacional utilizando registros médicos daneses de 1980 a 2012.
Se incluyeron pacientes con infarto de miocardio por primera vez y una cohorte de comparación de la población general emparejada (n=314, 911 infarto de miocardio; n=1, 573, 193 controles).
El análisis de regresión de Cox calculó los ratios de riesgo ajustados (aHR) para la demencia durante 35 años, controlando las comorbilidades y el estado socioeconómico.

Principales resultados:

El infarto de miocardio (IM) no se asoció con un mayor riesgo de demencia por cualquier causa (aHR, 1, 01).
El riesgo de enfermedad de Alzheimer (aHR, 0,92) y otras demencias fue similar al de la población general.
El infarto de miocardio se asoció con un riesgo significativamente mayor de demencia vascular (aHR, 1.35), particularmente en pacientes que experimentaron un ictus posterior al infarto de miocardio (aHR, 4.48).

Conclusiones:

El infarto de miocardio (IM) está relacionado con un mayor riesgo de demencia vascular, con un riesgo sustancialmente amplificado por el accidente cerebrovascular posterior al MI.
El riesgo de enfermedad de Alzheimer y otros tipos de demencia permanece sin cambios en las personas con antecedentes de infarto de miocardio.

Palabras clave:

La demencia Ciencias de la salud Infarto de miocardio Factores de riesgo

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