| Objective:To investigate the occurrence of cognitive impairment and related risk factors in patients with Coronary heart disease(CHD)Non-AMI CHD.Methods:Inpatients from The Second Hospital of Jilin University,aged 45-75 years,were diagnosed as non-AMI CHD non-acute myocardial infarction coronary heart disease after coronary angiography for the first time,a total of 120 cases.Cognitive function was assessed using the Montreal cognitive assessment(MoCA)scale.According to the score,there were 67 patients with normal cognitive function and 53 patients with cognitive impairment.To observe the incidence of cognitive impairment in patients with non-acute myocardial infarction coronary heart disease Non-AMI CHD,and to analyze the risk factors associated with cognitive impairment.Results:1.Measurement results and grouping of cognitive function of enrolled patientsAll patients used the MoCA scale to measure cognitive function.The results showed that in the 120 patients with Non-AMI CHD coronary heart disease,67 patients with a score of ? 26 were classified into normal cognitive function group,and 53 patients with a score of < 26 were classified into cognitive impairment group..2.Comparison of general clinical data results between the two groups of patientsThere were no significant differences in gender,BMI,place of residence,education,smoking history,smoking index,history of hypertension and history of diabetes between the two groups(P>0.05).3.Comparison of auxiliary examination results between the two groups of patientsComparison of auxiliary examination data between the two groups showed:Blood glucose(BG),Triglycerides(TG),Uric acid(UA),Serum creatinine(Scr),Blood cholesterol(Total Chollesterol,TC),Homocysteine(Hcy),Thyroid-stimulating hormone(TSH),Left Ventricular ejection fraction(LVEF),Fasting blood glucose(BG),Blood Triglyceride(TG),serum creatinine(Car),blood uric acid(UA),blood homocysteine(Hcy),total cholesterol(TC),thyrotropin(TSH),left ventricular ejection fraction(LVEF)There was no statistical difference(P>0.05).Compared with patients with cognitive function and cognitive impairment,the patients with cognitive impairment had older age,longer duration,and more severe coronary stenosis,and the difference was statistically significant(P<0.05).There were no significant differences in gender,BMI,place of residence,education,smoking history,smoking index,history of hypertension and history of diabetes between the two groups(P>0.05).Comparison of auxiliary examination data between the two groups showed: fasting blood glucose(BG),blood triglyceride(TG),serum creatinine(Car),blood uric acid(UA),blood homocysteine ??(Hcy),total bloodcholesterol(There were no significant differences in TC),thyrotropin(TSH),and left ventricular ejection fraction(LVEF)(P>0.05).4.Observe the incidence of cognitive impairment in the enrolled patientsThe patient's observation of the incidence of cognitive impairment showed that the number of cognitive impairment cases was 44.2% of the total number of cases.With the increase of age and the increase of Gensini score,the incidence of cognitive impairment increased,and the difference was statistically significant(P<0.05).Although there was no difference in the results of statistical analysis,the incidence of cognitive impairment increased in patients with low education,long duration,and history of smoking.5.Influence of coronary stenosis on cognitive function in patients with Non-AMI CHD(1)The abscissa is the independent variable(Gensini score),and the ordinate is the dependent variable(MoCA scale score)to draw a scatter plot,showing a negative correlation trend between the two variables.A linear correlation analysis between the Gensini score and the MoCA scale score confirmed that the two variables were negatively correlated.The Spearman correlation coefficient was-0.328,which was statistically significant(P=0.000<0.05).(2)According to the degree of coronary stenosis,the patients were divided into Gensini score ? 50 group and Gensini score > 50 groups,so that the degree of coronary stenosis became a two-class independent variable.Combine it with the dependent variable cognitive function into the binary logistic regression analysis model..The results showed that coronary stenosis was a risk factor for cognitive impairment in patients with Non-AMI CHD(OR=6.8,95% CI: 2.12-21.91,P=0.001<0.05).The risk of cognitive impairment in Non-AMI CHD patients with Gensini score >50 was 6.8 times higher than Gensini score ?50,and the results were statistically significant.6.Effects of smoking on cognitive impairment in patients with Non-AMI CHD(1)The smoking history and smoking index were not statistically differentbetween the cognitive function and the cognitive impairment group,but the incidence of cognitive impairment was higher in patients with coronary heart disease who had a history of smoking or a high smoking index.the trend of.(2)According to the smoking index,the patients were divided into smoking index ? 600 groups and smoking index > 600 groups,so that the smoking index became a two-category independent variable,and the cognitive function of the dependent variable was included in the binary logistic regression analysis model.The results showed that the smoking index was a risk factor for cognitive impairment in patients with Non-AMI CHD(OR=4.01,95% CI: 1.43-11.24,P=0.008<0.05),and Non-AMI CHD patients with coronary heart disease with a smoking index greater than 600.The risk of developing cognitive impairment was four times that of those with a smoking index of less than 600,and the results were statistically significant.7.Influence of course of disease on cognitive impairment in patients with Non-AMI CHDThe patients with angina pectoris were divided into three groups according to the course of disease: disease course ?1 year group,disease course 1-3 year group and disease course>3 year group,and then enter into binary logistic with independent variable course and dependent variable cognitive function.Regression model.The results showed that the duration of angina pectoris in 1-3 years and duration >3 years failed to show a correlation with cognitive impairment in Non-AMI CHD patients compared with ?1 year course(1-3 years: OR= 0.95,95%CI: 0.39-2.31,P=0.901;>3 years: OR=1.28,95% CI: 0.55-3.00,P=0.568).8.Age influence on cognitive impairment in patients with Non-AMI CHD(1)Correlation between age and MoCA scale score: The independent variable(age)is plotted on the abscissa,and the dependent variable(MoCA scale score)is plotted on the ordinate as a scatter plot showing a negative correlation between the two variables.Linear correlation analysis between age and MoCA scale scores showed that the changes were negatively correlated.The Spearman correlationcoefficient was-0.337,P=0.004<0.05,and the results were statistically significant.(2)Patients were divided into three groups according to age: 45-55 years old,56-65 years old,and 66-75 years old.The incidence of cognitive impairment in the three groups of Non-AMI CHD patients was compared.The results showed that the incidence of cognitive impairment in the 56-65 group was significantly higher than that in the 45-55 age group between 45-55 years old and 56-65 years old,the difference was statistically significant(P<0.017);56-65 years old group There was no significant difference in the incidence of cognitive impairment between the age group66-75(P>0.017).The cognitive impairment occurred in the 66-75 age group in the45-55 age group compared with the 66-75 age group.The rate was significantly higher than that in the 45-55 age group,and the difference was statistically significant(P <0.017).That is,Non-AMI CHD patients aged 56-75 years are more likely to have cognitive impairment than 45-55 years old;Non-AMI CHD patients aged 66-75 years have cognitive impairment compared with 56-65 age group There was no significant difference in incidence,but there was an increasing trend.(3)Incorporate independent variables(age segments)and dependent variables(cognitive functions)into a binary logistic regression model.The results showed that compared with the 45-55 age group,the risk factors for cognitive impairment in the56-65 age group(OR=3.13,95% CI: 1.27-7.71,P=0.013<0.05);and 45-55 The age of the 66-75 age group was also a risk factor for cognitive impairment compared with the age group(OR=3.57,95% CI: 1.28-9.96,P=0.015).The risk of cognitive impairment in patients with coronary heart disease in patients aged 56-75 years was more than three times higher than that in patients aged 45-55 years.The results were statistically significant.9.Univariate analysis of cognitive impairment in patients with Non-AMI CHDWhether or not cognitive impairment occurs in patients with Non-AMI CHD(No = 0,yes = 1),with gender(male = 1,female = 2),education level(high school and above level = 0;junior high school)Level below level = 1),place of residence(city = 0;rural = 1),obesity(no = 0;yes = 1),history of hypertension(no = 0;yes =1),history of diabetes(no = 0;Have = 1),hypertriglyceridemia(no = 0;= 1),hypercholesterolemia(no = 0;= 1)and hyperhomocysteinemia(no = 0;yes = 1)Incorporate a binary logistic regression analysis model for the independent variables.The results showed that none of the above variables showed a correlation with cognitive impairment.(Gender: OR=1.2,95% CI: 0.58-2.52,P=0.612);Education level:(OR=2.08,95% CI: 0.99-4.35,P=0.052);Place of residence:(OR=0.60,95% CI:0.26-1.36,P=0.221);Obesity(BMI?28):(OR=1.22,95% CI: 0.44-3.39,P=0.700);History of hypertension:(OR=1.34,95% CI :0.65-2.77,P=0.420);Diabetes history:(OR=1.14,95% CI: 0.50-2.62,P=0.750);Hypertriglyceridemia:(OR=1.34,95% CI:0.65-2.77,P=0.427);hypercholesterolemia:(OR=0.91,95% CI: 0.40-2.04,P=0.813);hyperhomocysteinemia:(OR=1.30,95% CI: 0.60-2.83,P = 0.510).10.Multivariate analysis of cognitive impairment in patients with Non-AMI CHDThe above independent and dependent variables were included in multivariate logistic regression analysis.After adjusting for confounding factors,the results showed that age,smoking history and Gensini score entered the final regression model(P<0.05).The age,smoking history,and coronary stenosis were independent risk factors for cognitive impairment in Non-AMI CHD patients.Conclusion:1.The cognitive function of patients with Non-AMI CHD is related to age,education level,smoking history,duration of angina pectoris and degree of coronary stenosis.The age,smoking history and coronary stenosis degree are recognized by Non-AMI CHD patients with coronary heart disease.Independent risk factors for impairment;2.In Non-AMI CHD patients with a history of smoking,the greater the smoking index,the worse the cognitive function. |
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