Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease
Background Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with coronary heart disease is more limited. Methods and Results The Montreal Cognitive Assessment score obtained 3.2±0.37 years after randomization to...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.010641 |
| _version_ | 1819178159698870272 |
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| author | Ralph A. H. Stewart Claes Held Sue Krug‐Gourley Dawn Waterworth Amanda Stebbins Karen Chiswell Emil Hagstrom Paul W. Armstrong Lars Wallentin Harvey White |
| author_facet | Ralph A. H. Stewart Claes Held Sue Krug‐Gourley Dawn Waterworth Amanda Stebbins Karen Chiswell Emil Hagstrom Paul W. Armstrong Lars Wallentin Harvey White |
| author_sort | Ralph A. H. Stewart |
| collection | DOAJ |
| description | Background Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with coronary heart disease is more limited. Methods and Results The Montreal Cognitive Assessment score obtained 3.2±0.37 years after randomization to darapladib, a reversible inhibitor of lipoprotein phospholipase A2 or placebo was evaluated for 10 634 patients with coronary heart disease from 38 countries in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial. The Montreal Cognitive Assessment scores for darapladib and placebo groups were similar (mean±SD, 25.3±3.84 versus 25.4±3.73, respectively; P=0.27) and the adjusted odds ratio (OR) for mild cognitive impairment (Montreal Cognitive Assessment score <26) was 1.00 (95% CI, 0.93–1.09). Mild cognitive impairment was more likely with increasing age (OR, 1.33 [1.27–1.41], +5 years after 65). For other baseline clinical characteristics, the strongest independent predictors of cognitive impairment were education (≤8 years versus college/university, OR, 2.95 [2.60–3.35]; >8 years/trade school versus college/university, OR, 1.38 [1.25–1.52] and geographic grouping). Cardiovascular risk factors independently associated with cognitive impairment were history of stroke (OR, 1.43 [1.20–1.71]); <2.5 hours of moderate or vigorous intensity exercise/week (OR, 1.19 [1.04–1.37]); high‐density lipoprotein cholesterol <1.16 mmol/L (OR, 1.19 [1.04–1.37]); diabetes mellitus requiring treatment (OR, yes versus no: 1.15 [1.05–1.26]); and history of hypertension (OR, 1.12 [1.02–1.23]). Conclusions In patients with stable coronary heart disease, cognitive performance was associated with modifiable cardiovascular risk factors, educational level, and global region, but was not influenced by darapladib. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00799903. |
| first_indexed | 2024-12-22T21:38:07Z |
| format | Article |
| id | doaj.art-0867d6f57a9d49588b04100e233f20fe |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:38:07Z |
| publishDate | 2019-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-0867d6f57a9d49588b04100e233f20fe2022-12-21T18:11:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-04-018710.1161/JAHA.118.010641Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart DiseaseRalph A. H. Stewart0Claes Held1Sue Krug‐Gourley2Dawn Waterworth3Amanda Stebbins4Karen Chiswell5Emil Hagstrom6Paul W. Armstrong7Lars Wallentin8Harvey White9Green Lane Cardiovascular Service Auckland City Hospital Auckland New ZealandDepartment of Medical Sciences Cardiology Uppsala University Uppsala SwedenMetabolic Pathways and Cardiovascular Medicine Delivery Unit GlaxoSmithKline Research and Development Collegeville PADepartment of Genetics GlaxoSmithKline Medicines Research Centre Upper Merion Philadelphia PADuke Clinical Research Institute Durham NCDuke Clinical Research Institute Durham NCDepartment of Medical Sciences Cardiology Uppsala University Uppsala SwedenCanadian VIGOUR Centre University of Alberta Edmonton CanadaDepartment of Medical Sciences Cardiology Uppsala University Uppsala SwedenGreen Lane Cardiovascular Service Auckland City Hospital Auckland New ZealandBackground Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with coronary heart disease is more limited. Methods and Results The Montreal Cognitive Assessment score obtained 3.2±0.37 years after randomization to darapladib, a reversible inhibitor of lipoprotein phospholipase A2 or placebo was evaluated for 10 634 patients with coronary heart disease from 38 countries in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial. The Montreal Cognitive Assessment scores for darapladib and placebo groups were similar (mean±SD, 25.3±3.84 versus 25.4±3.73, respectively; P=0.27) and the adjusted odds ratio (OR) for mild cognitive impairment (Montreal Cognitive Assessment score <26) was 1.00 (95% CI, 0.93–1.09). Mild cognitive impairment was more likely with increasing age (OR, 1.33 [1.27–1.41], +5 years after 65). For other baseline clinical characteristics, the strongest independent predictors of cognitive impairment were education (≤8 years versus college/university, OR, 2.95 [2.60–3.35]; >8 years/trade school versus college/university, OR, 1.38 [1.25–1.52] and geographic grouping). Cardiovascular risk factors independently associated with cognitive impairment were history of stroke (OR, 1.43 [1.20–1.71]); <2.5 hours of moderate or vigorous intensity exercise/week (OR, 1.19 [1.04–1.37]); high‐density lipoprotein cholesterol <1.16 mmol/L (OR, 1.19 [1.04–1.37]); diabetes mellitus requiring treatment (OR, yes versus no: 1.15 [1.05–1.26]); and history of hypertension (OR, 1.12 [1.02–1.23]). Conclusions In patients with stable coronary heart disease, cognitive performance was associated with modifiable cardiovascular risk factors, educational level, and global region, but was not influenced by darapladib. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00799903.https://www.ahajournals.org/doi/10.1161/JAHA.118.010641cognitive impairmentcoronary heart diseaseMontreal Cognitive Assessmentrisk factor |
| spellingShingle | Ralph A. H. Stewart Claes Held Sue Krug‐Gourley Dawn Waterworth Amanda Stebbins Karen Chiswell Emil Hagstrom Paul W. Armstrong Lars Wallentin Harvey White Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cognitive impairment coronary heart disease Montreal Cognitive Assessment risk factor |
| title | Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease |
| title_full | Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease |
| title_fullStr | Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease |
| title_full_unstemmed | Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease |
| title_short | Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease |
| title_sort | cardiovascular and lifestyle risk factors and cognitive function in patients with stable coronary heart disease |
| topic | cognitive impairment coronary heart disease Montreal Cognitive Assessment risk factor |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.010641 |
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