心筋梗塞の生存者における血管性認知症のリスクが高い
Jens Sundbøll1,2, Erzsébet Horváth-Puhó3, Kasper Adelborg3,2
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.
Circulation
|October 14, 2017
まとめ
心筋梗塞 (MI) の生存者は,特に脳卒中を患う場合,血管性認知症のリスクが高まります. しかし,MIはアルツハイマー病や他の認知症のリスクを高めません.
科学分野:
- 心血管医学
- 神経学
- 流行病学について
背景:
- 心筋梗塞 (MI) の生存者は,動脈硬化や脳卒中などの共通の危険因子により,認知症のリスクが高くなります.
- 心臓発作後の認知症のリスクを調査することは,長期的な健康上の結果を理解するために極めて重要です.
研究 の 目的:
- 1年後の生存者における心筋梗塞 (MI) とその後の認知症の発症リスクとの関連を調べる.
- MI後の様々な認知症サブタイプ (アルツハイマー病,血管性認知症,その他の認知症) のリスクを区分する.
主な方法:
- 1980年から2012年にかけてのデンマークの医療記録を用いた全国的な集団調査.
- 初発性MI患者と一致した一般集団比較コホート (n=314, 911 MI; n=1, 573, 193対照群) を含めた.
- コックス回帰分析では,併発症と社会経済的地位をコントロールした35年間の認知症に対する調整されたリスク比率 (aHR) を計算した.
主要な成果:
- 心筋梗塞 (MI) は全因性認知症のリスク増加と関連しませんでした (aHR,1. 01).
- アルツハイマー病 (aHR,0. 92) と他の認知症のリスクは,一般の人々と同等であった.
- MIは血管性認知症 (aHR,1. 35),特に脳卒中後に発症した患者 (aHR,4. 48) の有意に高いリスクと関連していました.
結論:
- 心筋梗塞 (MI) は,血管性認知症のリスクの増加と関連しており,脳卒中後のリスクは大幅に増加しています.
- アルツハイマー病やその他の認知症のリスクは,先例のMI患者では変わっていない.
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