Correlation Between SNYTAX Score And Vascular Dementia In Elderly Patients With Coronary Heart Disease

With the improvement of science technology and the development of the social economy,the average life expectancy of human beings has been significantly longer than in the past,and the world has entered an ageing society.As the most populous country in the world,China will face severe challenges in adapting to an aging population.More and more people may suffer from varying degree of dementia with aging.Dementia is a neurological disease that causes multiple cognitive domains to decline with functional impairment.Ii will seriously affect the quality of patients' life,and bring heavy burden to families and society.The prevalence of dementia is gradually increasing,and it has always been a public health issue of concern.Vascular dementia(VD)is one of the major types of senile dementia,its prevalence is only lower than that of Alzheimer's disease(AD).However,with the improvement of living standards,aging of the age structure of the population,increasing incidence of cardiovascular and cerebrovascular diseases,the prevalence of vascular dementia has a clear upward trend.Vascular dementia is difficult to reverse once it occurs,but its etiology is clear and risk factors can be discovered and controlled,early intervention and prevention are expected to reduce the disability of the disease.Therefore,any factors that may affect the disease are worth explored.At present,there are many studies on the factors affecting vascular dementia,but most of them are related to age,cultural level,hyperlipidemia,hypertension,diabetes,carotid atherosclerosis,and cerebral infarction.The relevant research indicators are mostly blood composition parameters.A large number of reports have confirmed that coronary heart disease(CHD)is a risk factor for vascular dementia,and it is also a common disease of chronic diseases in the elderly in China,but the complexity of the lesion has rarely been reported on the occurrence of vascular dementia.The proposed SNYTAX score can objectively evaluate the degree of coronary artery lesions on the basis of coronary angiography,it can be a more reliable risk parameter for patients with coronary heart disease.In recent years,the study of SNYTAX score has shown that it is an independent predictor of major adverse cardiovascular and cerebrovascular events(MACCE)in patients with coronary heart disease after PCI or CABG.It can effectively guide clinicians to choose moreappropriate treatment for patients with coronary heart disease.There are also studies show that SNYTAX score have a certain relationship with risk factors for vascular dementia.Thus,in this study,we started with SNYTAX score directly to investigate the effects of different SNYTAX scores on vascular dementia in elderly patients with coronary heart disease,that is,the influence of the complexity of coronary artery lesion on vascular dementia.Through the common angiographic operation,in the diagnosis of coronary heart disease and the assessment of the severity of coronary artery disease,it is expected that early screening for vascular dementia,to prevent the occurrence of vascular dementia.ObjectiveThis article aims to preliminarily explore the correlation between coronary angiography SNYTAX score and vascular dementia in elderly patients with coronary heart disease,so that early screening for vascular dementia,so can provide a more accurate theoretical basis for the prevention of vascular dementia in elderly patients with coronary heart disease.Materials and MethodsSelect 140 cases elderly patients with coronary heart disease hospitalized in the Department of Cardiology of the First Affiliated Hospital of Chengdu Medical College from September 2016 to September 2017.SNYTAX scores were calculated according to the results of angiography and divided into three groups: low score group,middle score group and high score group.Vascular dementia was diagnosed by MMSE,Hachinski Ischemia Scale and related diagnostic criteria.Then divided into vascular dementia group and non-vascular dementia group.First of all,the general information,related medical history,SNYTAX score,and MMSE score were compared between the vascular dementia group and the non-vascular dementia group.And then,the significant factors of univariate analysis were analyzed by multivariate analysis to evaluate their effects to vascular dementia.Moreover,the general information,related medical history,MMSE score were analyzed among SNYTAX score groups.Finally,the differences in the prevalence of vascular dementiawere compared among different SNYTAX score groups in elderly patients with coronary heart disease.Using SPSS 21.0 software for statistical analysis,counting data was expressed by the number of cases(rate or percentage),using the ?2 test,measurement data was expressed by mean ± standard deviation(`x ± s)or dedian,using F test,t test or rank sum test.As for multivariate,using logistic regression analysis.Results1.Compared vascular dementia group and non-vascular dementia group,there was no significant difference in gender(P>0.05),while the differences were statistically significant(P<0.05)in age,degree of educational,smoking history,history of hyperlipidemia,history of hypertension,history of diabetes,MMSE score and SNYTAX score.The results of logistic regression analysis showed that,the OR of the age,SNYTAX score and degree of educational are 1.098,1.056 and 0.825,respectively.with the increase of age and SNYTAX,the risk of vascular dementia tend to increase,while the risk of vascular dementia tend to decrease as the educational level increased.2.There was no significant difference in general information such as gender,age,educational level(P>0.05)among the three groups(low score group,meddle score group and high score group).In terms of hobby and related medical history of the three groups,there was no significant difference(P>0.05)in history of smoking,history of hypertension,history of hyperlipidaemia and history of diabetes.The differences of MMSE scores among the low score group,middle score group and high score group were statistically significant(P<0.05).3.The difference was statistically significant(P<0.05)in the prevalence of vascular dementia among the three groups of low score group,middle score group and high score group.The low score group had the lowest prevalence while the high score group had the highest prevalence.And then a pairwise comparison of statistical analysis,in which low score group compared with the meddle score group,the difference was no statistically significant(P>0.05/3).The differences between low score group and high score group,middle score group and high-score group were both statistically significant(P<0.05/3).Conclusion1.Age,degree of education,smoking,hyperlipidemia,hypertension and diabetes are all affecting factors of vascular dementia.The age of vascular dementia group is higher than that of non-vascular dementia group,it is a risk factor of vascular dementia.While education level of vascular dementia group is lower than that of non-vascular dementia group,it is a protective factor of vascular dementia.2.The SNYTAX score of vascular dementia group was higher than that of non-vascular dementia group,SNYTAX score(the degree of coronary artery lesion)is a risk factor of vascular dementia.3.The prevalence of vascular dementia in the high score group was significantly higher than that in the low and middle group,and elderly patients with coronary heart disease with coronary artery severe lesions are more likely to develop vascular dementia than patients with mild to moderate lesions.