Novel Indices of Cognitive Impairment and Incident Cardiovascular Outcomes in the REWIND Trial.

Autor:	Cukierman-Yaffe T; Endocrinology Institute, Sheba Medical Center, Ramat-Gan, and Epidemiology Department, Sackler School of Medicine, Herceg Institute of Aging, Tel Aviv University, Tel Aviv, Israel., Gerstein HC; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada., Basile J; Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, USA., Bethel MA; Eli Lilly and Company, Indianapolis, IN, USA., Cardona-Muñoz EG; CUCS-Universidad de Guadalajara, Mexico., Conget I; Endocrinology and Nutrition Dpt. Hospital Clinic i Universitari, Barcelona, Spain., Dagenais G; Quebec Heart and Lung Institute, Laval University, Quebec City, Canada., Franek E; Mossakowski Medical Research Centre, Polish Academy of Sciences and Central Clinical Hospital MSWiA, Warsaw, Poland., Hall S; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada., Hancu N; Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania., Jansky P; University Hospital Motol, Prague., Lakshmanan M; Eli Lilly and Company, Indianapolis, IN, USA., Lanas F; Universidad de La Frontera, Temuco, Chile., Leiter LA; Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada., Lopez-Jaramillo P; Masira Research Institute, Medical School, Universidad de Santander UDES, Bucaramanga, Colombia., Pirags V; University of Latvia, Pauls Stradiņš Clinical University Hospital, Riga, Latvia., Pogosova N; National Medical Research Center of Cardiology, Moscow, Russia., Probstfield J; Department of Medicine, University of Washington, Seattle, WA,USA., Rao-Melacini P; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada., Ramasundarahettige C; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada., Raubenheimer PJ; Department of Medicine, University of Cape Town, Cape Town, South Africa., Riddle MC; Department of Medicine, Oregon Health & Science University Portland, OR, USA., Rydén L; Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden., Shaw JE; Baker Heart and Diabetes Institute, Melbourne, Australia., Sheu WH; Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan., Temelkova-Kurktschiev T; Robert Koch Medical Center, Sofia, Bulgaria.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2022 Jul 14; Vol. 107 (8), pp. e3448-e3454.
DOI:	10.1210/clinem/dgac200
Abstrakt:	Context: Low cognitive scores are risk factors for cardiovascular outcomes. Whether this relationship is stronger using novel cognitive indices is unknown. Methods: Participants in the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial who completed both the Montreal Cognitive Assessment (MoCA) score and Digit Substitution Test (DSST) at baseline (N = 8772) were included. These scores were used to identify participants with baseline substantive cognitive impairment (SCI), defined as a baseline score on either the MoCA or DSST ≥ 1.5 SD below either score's country-specific mean, or SCI-GM, which was based on a composite index of both scores calculated as their geometric mean (GM), and defined as a score that was ≥ 1.5 SD below their country's average GM. Relationships between these measures and incident major adverse cardiovascular events (MACE), and either stroke or death were analyzed. Results: Compared with 7867 (89.7%) unaffected participants, the 905 (10.3%) participants with baseline SCI had a higher incidence of MACE (unadjusted hazard ratio [HR] 1.34; 95% CI 1.11, 1.62; P = 0.003), and stroke or death (unadjusted HR 1.60; 95% CI 1.33, 1.91; P < 0.001). Stronger relationships were noted for SCI-GM and MACE (unadjusted HR 1.61; 95% CI 1.28, 2.01; P < 0.001), and stroke or death (unadjusted HR 1.85; 95% CI 1.50, 2.30; P < 0.001). For SCI-GM but not SCI, all these relationships remained significant in models that adjusted for up to 10 SCI risk factors. Conclusion: Country-standardized SCI-GM was a strong independent predictor of cardiovascular events in people with type 2 diabetes in the REWIND trial. (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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