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Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease
Auckland City Hosp, Green Lane Cardiovasc Serv, Private Bag 92024, Auckland 1030, New Zealand;Univ Auckland, Auckland, New Zealand.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.ORCID iD: 0000-0001-9402-7404
GlaxoSmithKline Res & Dev Ltd, Metab Pathways & Cardiovasc Med Delivery Unit, Collegeville, PA USA.
GlaxoSmithKlIne Med Res Ctr, Dept Genet, Philadelphia, PA USA.
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2019 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 8, no 7, article id e010641Article in journal (Refereed) Published
Abstract [en]

Background-Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with coronary heart disease is more limited. Methods and Results-The Montreal Cognitive Assessment score obtained 3.2 +/- 0.37 years after randomization to darapladib, a reversible inhibitor of lipoprotein phospholipase A2 or placebo was evaluated for 10 634 patients with coronary heart disease from 38 countries in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial. The Montreal Cognitive Assessment scores for darapladib and placebo groups were similar (mean +/- SD, 25.3 +/- 3.84 versus 25.4 +/- 3.73, respectively; P=0.27) and the adjusted odds ratio (OR) for mild cognitive impairment (Montreal Cognitive Assessment score <26) was 1.00 (95% CI, 0.93-1.09). Mild cognitive impairment was more likely with increasing age (OR, 1.33 [1.27-1.41], +5 years after 65). For other baseline clinical characteristics, the strongest independent predictors of cognitive impairment were education (<= 8 years versus college/university, OR, 2.95 [2.60-3.35]; >8 years/trade school versus college/university, OR, 1.38 [1.25-1.52] and geographic grouping). Cardiovascular risk factors independently associated with cognitive impairment were history of stroke (OR, 1.43 [1.20-1.71]); <2.5 hours of moderate or vigorous intensity exercise/week (OR, 1.19 [1.04-1.37]); high-density lipoprotein cholesterol <1.16 mmol/L (OR, 1.19 [1.04-1.37]); diabetes mellitus requiring treatment (OR, yes versus no: 1.15 [1.05-1.26]); and history of hypertension (OR, 1.12 [1.02-1.23]). Conclusions-In patients with stable coronary heart disease, cognitive performance was associated with modifiable cardiovascular risk factors, educational level, and global region, but was not influenced by darapladib.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 8, no 7, article id e010641
Keywords [en]
cognitive impairment, coronary heart disease, Montreal Cognitive Assessment, risk factor
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-394175DOI: 10.1161/JAHA.118.010641ISI: 000484574300006PubMedID: 30897999OAI: oai:DiVA.org:uu-394175DiVA, id: diva2:1358659
Available from: 2019-10-08 Created: 2019-10-08 Last updated: 2019-10-08Bibliographically approved

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Held, ClaesHagström, EmilWallentin, Lars
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