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

Autor:	Tomioka T; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Takahashi R; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Ikumi Y; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Tanaka S; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Ito Y; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Shioiri H; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Koyama J; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan., Inoue K; Department of Cardiology, South-Miyagi Medical Center, Miyagi, Japan.
Jazyk:	angličtina
Zdroj:	Journal of geriatric cardiology : JGC [J Geriatr Cardiol] 2019 Oct; Vol. 16 (10), pp. 733-740.
DOI:	10.11909/j.issn.1671-5411.2019.10.005
Abstrakt:	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, χ 2 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 CI partner. To improve patients' prognoses, social background should be considered alongside conventional medical measures. (Institute of Geriatric Cardiology.)
Databáze:	MEDLINE
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