在非ST升高急性冠状动脉综合征的老年人中,认知障碍和结果
Valerie Josephine Dirjayanto1,2, Mohammad Alkhalil1,3, John Dodson4
1Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Heart (British Cardiac Society)
|October 9, 2023
概括
在接受侵入性治疗的非ST升高急性冠状动脉综合征 (NSTEACS) 的老年患者中,认知障碍并没有增加主要的心血管不良事件. 然而,认知障碍与长期全因死亡风险更高有关.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 神经科学是一个神经科学.
背景情况:
- 接受侵入性治疗的非ST升高急性冠状动脉综合征 (NSTEACS) 的老年患者有不良结果的风险.
- 在这个特定的人群中,认知障碍的预后影响需要进一步调查.
研究的目的:
- 探索认知障碍对主要不良心血管事件 (MACE) 和老年NSTEACS患者进行侵入性治疗的全因死亡率的预后影响.
- 评估基线认知状态与长期心血管结果之间的关联.
主要方法:
- 一项多中心前性研究包括75岁以上的NSTEACS患者接受侵入性策略.
- 认知状态在基线时使用蒙特利尔认知评估 (分数≥26:正常;<26:认知障碍) 进行评估.
- 收集了长期随访数据,以确定主要终点:MACE (死亡,心脏复发,中风/TIA,紧急重血管,显著出血的组合).
主要成果:
- 239名患者完成了长期随访;中位数年龄为80.9岁,62.3%是男性.
- 在5年随访期间,认知障碍和正常认知组之间没有观察到MACE发生的显著差异 (p=0.155).
- 认知障碍与长期全因死亡率的增加显著相关 (aHR为1.85; p=0.018),即使经过对脆弱性和GRACE评分进行调整.
结论:
- 接受侵入性治疗的NSTEACS老年患者的认知障碍与长期增加的全因死亡率有关.
- 常规认知查可能会改善这一患者群体的风险分层.
- 需要进一步的研究来指导基于认知状态的管理策略.
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