A Study On Influencing Factors Of Cognitive Impairment In Patients Of Coronary Chronic Total Occlusion

Objective This study explored the incidence of cognitive impairment in patients with coronary chronic total occlusion（CTO）and its related influencing factors,so as to provide theoretical references for the prevention and treatment of cognitive impairment in CTO patients.Methods A total of 212 patients diagnosed as CTO who underwent coronary angiography in the Department of Cardiovascular Medicine,The First Affiliated Hospital of Anhui Medical University from July 2019 to July 2021 were included in the study.Their basic information,smoking history,diabetes history,history of hypertension and history of atrial fibrillation were collected,and auxiliary examination indicators and SYNTAX score were recorded.Montreal Cognitive Assessment Scale（Mo CA）was used to evaluate the cognitive function of the patients.According to Mo CA score,the patients were divided into normal cognitive function group（n=145）and impaired cognitive function group（n=67）.The indicators and scores of seven subitems of Mo CA score were compared between the two groups by statistical methods,and the influencing factors of cognitive impairment in CTO patients were analyzed by Logistic regression analysis.Results Among 212 patients with CTO,67 patients（31.6%）developed cognitive impairment.The impaired cognitive function group was older [（71.42±6.65）vs（54.79±10.56）] and had higher serum uric acid levels [（402.40±101.01）vs（365.30±103.02）] than the normal cognitive function group.The left ventricular ejection fraction was lower [（53.73±6.59）vs（57.09±4.56）],and the differences were statistically significant（P < 0.05）.There was no difference in other general clinical data between the two groups（P > 0.05）.The visuospatial and executive ability（2.40±0.84）,attention and computation ability（2.24±1.00）and language expression ability（2.25±0.72）in the impaired cognitive function group were significantly lower than those in the normal cognitive function group,with statistical significance（P < 0.05）.Binary Logistic regression analysis showed that SYNTAX score ≥33（high risk）was a risk factor for cognitive impairment in CTO patients（OR=5.399,95%CI:2.773-10.509,P<0.05）.In addition,multivariate Logistic regression analysis of age,uric acid,left ventricular ejection fraction and high SYNTAX score（≥33）showed that old age,high uric acid and low left ventricular ejection fraction were independent risk factors for cognitive impairment in CTO patients.Conclusion1.The CTO patients with old age,high uric acid and low left ventricular systolic function have a higher risk of cognitive impairment.2.CTO patients with SYNTAX score ≥33 may have a higher incidence of cognitive impairment.3.Cognitive impairment occurs in 31.6% of CTO patients.Cognitive impairment in CTO patients is mainly reflected in visuospatial and executive ability,attention and computation ability,and verbal expression ability.