The independent impact of dementia in patients undergoing percutaneous coronary intervention for acute myocardial infarction.
death
dementia
major adverse cardiac event
myocardial infarction
percutaneous coronary intervention
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
revised:
07
12
2022
received:
03
08
2022
accepted:
19
12
2022
pubmed:
13
1
2023
medline:
21
3
2023
entrez:
12
1
2023
Statut:
ppublish
Résumé
Although age and frailty are associated with worse prognoses for patients who undergo percutaneous coronary intervention (PCI), little is known regarding the independent impact of dementia. The aim of this study was to evaluate the association between dementia and outcomes for patients with acute myocardial infarction (AMI). Consecutive patients with ST-elevation or non-ST elevation MI who had undergone PCI as part of our AMI registry were included in this study. We compared outcomes within the 1-year period of their PCI, including death and major adverse cardiac events (MACE) and corrected for confounders using Cox regression. Of 28 274 patients, 9167 patients who had undergone PCI for AMI were included in this study, 250 with dementia; Mean age (77.4 ± 9.4 in the dementia group vs. 63.6 ± 12.7 in the control), female gender (32.4 vs. 24.2%, p = .003), diabetes mellitus (54.0 vs. 42.4%, p < .001) and chronic kidney disease (44.4 vs. 19.3%, p < .001) were higher. At 12 months, unadjusted rates of death (25.5 vs. 9.8%, p < .001) and MACE (33.8 vs. 17.6%, p < .001) were higher for patients with dementia. After standardizing for confounding variables, dementia remained an independent risk factor for death (HR 1.90; CI 1.37-2.65; p < .001) and MACE (HR 1.73; CI 1.30-2.31; p < .001), as well as in propensity score matched analysis (HR 1.54; CI: 1.03-2.28; p < .001 and HR 1.49; CI: 1.09-2.02; p < .001, respectively). Dementia is an independent predictor of worse outcomes in patients undergoing PCI for AMI. Future intervention and specialized healthcare measures to mitigate this risk is warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Although age and frailty are associated with worse prognoses for patients who undergo percutaneous coronary intervention (PCI), little is known regarding the independent impact of dementia.
HYPOTHESIS
OBJECTIVE
The aim of this study was to evaluate the association between dementia and outcomes for patients with acute myocardial infarction (AMI).
METHODS
METHODS
Consecutive patients with ST-elevation or non-ST elevation MI who had undergone PCI as part of our AMI registry were included in this study. We compared outcomes within the 1-year period of their PCI, including death and major adverse cardiac events (MACE) and corrected for confounders using Cox regression.
RESULTS
RESULTS
Of 28 274 patients, 9167 patients who had undergone PCI for AMI were included in this study, 250 with dementia; Mean age (77.4 ± 9.4 in the dementia group vs. 63.6 ± 12.7 in the control), female gender (32.4 vs. 24.2%, p = .003), diabetes mellitus (54.0 vs. 42.4%, p < .001) and chronic kidney disease (44.4 vs. 19.3%, p < .001) were higher. At 12 months, unadjusted rates of death (25.5 vs. 9.8%, p < .001) and MACE (33.8 vs. 17.6%, p < .001) were higher for patients with dementia. After standardizing for confounding variables, dementia remained an independent risk factor for death (HR 1.90; CI 1.37-2.65; p < .001) and MACE (HR 1.73; CI 1.30-2.31; p < .001), as well as in propensity score matched analysis (HR 1.54; CI: 1.03-2.28; p < .001 and HR 1.49; CI: 1.09-2.02; p < .001, respectively).
CONCLUSIONS
CONCLUSIONS
Dementia is an independent predictor of worse outcomes in patients undergoing PCI for AMI. Future intervention and specialized healthcare measures to mitigate this risk is warranted.
Identifiants
pubmed: 36632766
doi: 10.1002/clc.23967
pmc: PMC10018096
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
279-286Informations de copyright
© 2023 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.
Références
Lancet Neurol. 2019 Jan;18(1):88-106
pubmed: 30497964
CMAJ. 2005 Aug 30;173(5):489-95
pubmed: 16129869
Drugs Aging. 2012 Oct;29(10):819-28
pubmed: 23018581
Eur Heart J. 2019 Jan 14;40(3):237-269
pubmed: 30165617
J Am Geriatr Soc. 2013 Nov;61(11):1932-6
pubmed: 24219195
QJM. 2006 Dec;99(12):851-62
pubmed: 17121766
J Clin Med. 2021 May 30;10(11):
pubmed: 34070865
Curr Probl Cardiol. 2022 Oct;47(10):100960
pubmed: 34363848
Circulation. 2002 May 21;105(20):2378-84
pubmed: 12021224
Clin Cardiol. 2023 Mar;46(3):279-286
pubmed: 36632766
J Am Heart Assoc. 2013 Dec 18;2(6):e000369
pubmed: 24351701
J Am Coll Cardiol. 2006 Dec 19;48(12):2584-91
pubmed: 17174201
PLoS One. 2017 Sep 8;12(9):e0184244
pubmed: 28886155
Clin Anat. 1996;9(2):118-27
pubmed: 8720786
Open Heart. 2015 Sep 08;2(1):e000294
pubmed: 26380099
J Gerontol A Biol Sci Med Sci. 2021 Aug 13;76(9):1633-1642
pubmed: 33057609
Clin Epidemiol. 2013 Apr 26;5:135-45
pubmed: 23658499
Int Heart J. 2008 Sep;49(5):533-43
pubmed: 18971565
Acta Med Indones. 2016 Apr;48(2):91-8
pubmed: 27550877
Int J Cardiol. 2017 Feb 1;228:456-458
pubmed: 27870976
J Am Med Dir Assoc. 2017 Dec 1;18(12):1097.e1-1097.e10
pubmed: 29079033
J Cardiol. 2015 Sep;66(3):263-8
pubmed: 25547740
J Am Geriatr Soc. 2004 Feb;52(2):173-81
pubmed: 14728624
Int J Geriatr Psychiatry. 2015 Mar;30(3):234-46
pubmed: 25504093
Am Heart J. 2014 Nov;168(5):784-91
pubmed: 25440808
Neurobiol Aging. 2005 Jun;26(6):865-71
pubmed: 15718045
Cureus. 2020 Jul 23;12(7):e9349
pubmed: 32742886
Mayo Clin Proc. 2017 Jun;92(6):934-939
pubmed: 28389067
J Am Coll Cardiol. 2000 Sep;36(3):723-30
pubmed: 10987591
Int J Geriatr Psychiatry. 2014 Sep;29(9):906-14
pubmed: 24523068
Am J Cardiol. 2008 May 15;101(10):1379-83
pubmed: 18471445
Circ J. 2007 Sep;71(9):1354-9
pubmed: 17721010
Am J Cardiol. 2007 Sep 1;100(5):787-92
pubmed: 17719321