Influence of cognitive impairment on cardiac mortality after percutaneous coronary intervention in very elderly patients: a retrospective observational study

• 来源期刊: 老年心脏病学杂志（英文版）
• 年，卷（期）: 2019,（10）
• 页码范围: 733-740
• 页数: 8页
• 语种: 英文
• DOI: 10.11909/j.issn.1671-5411.2019.10.005

摘要

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,x2 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 Cl partner.To improve patients' prognoses,social background should be considered alongside conventional medical measures.