Risk Factors And Cognitive Domain Analysis Of Cognitive Impairment In The Acute Phase Of Minor Ischemic Stroke

Objective: To investigate the risk factors of cognitive impairment and the relationship between the risk factors and cognitive domain in the acute phase of minor ischemic stroke.Methods: 83 patients diagnosed with minor ischemic stroke in the Neurology Department of the First Affiliated Hospital of China Medical University from October2021 to November 2022 were selected.And the clinical data of each patient were collected,including demography data,disease history,laboratory tests and imaging tests.According to the Montreal Cognitive Assessment Scale(Mo CA)score,it was divided into the cognitive impairment group and the non cognitive impairment group in the acute phase of minor ischemic stroke(the cognitive impairment group is defined as a Mo CA total score ≤ 22 points).SPSS 26.0 software was used for data analysis and processing.Univariate analysis was conducted on all clinical data of patients who met the inclusion and exclusion criteria.Univariate factors with significant differences between the two groups was included in the binary logistic regression analysis.Receiver operating characteristic curve was drawn to analyze the predictive effect of risk factors on cognitive impairment.And Spearman correlation analysis was performed on the relationship between risk factors and cognitive domains.Results: 1.There were significant differences in Hb A1c(P<0.001),years of education(P=0.019),previous stroke history(P=0.001),white matter hyperintensity(P<0.001),stroke site(P=0.041)and whether or not thalamic infarction(P=0.028)between the two groups.And there were no significant differences in age,sex,BMI,fasting blood glucose,hypertension,diabetes,and coronary heart disease eg.2.Binary logistic regression analysis showed that Hb A1c(P=0.004,β=0.469,OR=1.598,95%CI:1.106-2.038),previous stroke history(P=0.049,β=1.161,OR=3.194,95%CI:0.989-10.309)and white matter hyperintensity(P<0.001,β=0.581,OR=1.787,95%CI:1.252-2.551)were independent risk factors for cognitive impairment in the acute phase of minor ischemic stroke.And ROC curve analysis was performed on Hb A1 c and white matter hyperintensity,and it was found that the area under the Hb A1 c curve was larger,with AUC=0.759,sensitivity=0.85,specificity=0.71,Jordan index=0.57,and optimal cutoff value=5.95.3.The differences in adjusted Mo CA total score(P<0.001),visual space and executive function(P<0.001),attention(P=0.001),language(P=0.001),abstraction(P<0.001)and delayed recall(P<0.001)between the two groups were statistically significant.4.Spearman correlation analysis showed that Hb A1c(P=0.003,r=-0.322),white matter hyperintensity(P<0.001,r=-0.384)and executive function were negatively correlated,while Hb A1c(P=0.002,r=-0.330),white matter hyperintensity(P=0.001,r=-0.343)and previous stroke history(P<0.001,r=-0.393)were negatively correlated with delayed recall.Other correlation analyses were not statistically significant.Conclusions: 1.There is significant cognitive impairment in the acute phase of minor ischemic stroke and the damage to the cognitive domain is extensive;2.Hb A1 c,white matter hyperintensity and previous stroke history are important risk factors for cognitive impairment in the acute phase of minor ischemic stroke;Hb A1 c may serve as a predictive factor for cognitive impairment in MIS patients during the acute phase;3.Hb A1 c and white matter hyperintensity may be associated with impaired executive function in patients with minor ischemic stroke during the acute phase;Minor ischemic stroke patients with high Hb A1 c,white matter hyperintensity and previous stroke history may have more significant delayed recall impairment in the acute phase.