Hutter I, Kovacicova L, Jacomella V, Husmann M, Clemens R, Amann-Vesti B
Clinic for Angiology, University Hospital, Zürich, Switzerland -
Int Angiol. 2015 Oct;34(5):459-66. Epub 2014 Nov 14.
The aim of the present study was to examine the association between cardiovascular comorbidities and risk factors, and cognitive function in peripheral artery disease (PAD) patients, as well as to determine the influence of cognitive function on cardiovascular outcome in a two-year follow-up.
The cognitive function of 104 PAD patients was assessed using the mini-mental test (MMSE). Ankle Brachial Index (ABI), Fontaine stage, PAD localization, cardiovascular risk factors and comorbidities were taken from the electronic patient charts. A multiple logistic regression model, which included myocardial infarction (MI), stroke/transient ischemic attack (TIA), diabetes mellitus (DM), coronary heart disease (CHD) and smoking was performed to compare patients with and without cognitive impairment. All study participants were followed for two years in order to evaluate their cardiovascular outcome, mortality and revascularisation rate.
There was no significant difference in mini-mental state between asymptomatic and symptomatic PAD patients. ABI and PAD localization was not related to cognitive function. However, pre-existing stroke, TIA, coronary artery disease (CAD) or DM were associated with a lower MMSE score. When MMSE was dichotomized in ≤27 and >27 points, the presence of CAD, history of cerebrovascular events and DM was associated with a MMSE ≤27 in multivariate analysis. There was no association between MMSE and cardiovascular event rate.
PAD patients with CAD, stroke, TIA or DM have worse cognitive function than those without these factors. There was no evidence that cognitve function influenced cardiovascular outcome.
本研究旨在探讨外周动脉疾病(PAD)患者心血管合并症及危险因素与认知功能之间的关联,并在两年随访中确定认知功能对心血管结局的影响。
采用简易精神状态检查表(MMSE)评估104例PAD患者的认知功能。从电子病历中获取踝臂指数(ABI)、Fontaine分期、PAD部位、心血管危险因素及合并症。采用多元逻辑回归模型,纳入心肌梗死(MI)、中风/短暂性脑缺血发作(TIA)、糖尿病(DM)、冠心病(CHD)和吸烟情况,对有认知障碍和无认知障碍的患者进行比较。对所有研究参与者进行两年随访,以评估其心血管结局、死亡率和血管再通率。
无症状和有症状的PAD患者在简易精神状态方面无显著差异。ABI和PAD部位与认知功能无关。然而,既往有中风、TIA、冠状动脉疾病(CAD)或DM与较低的MMSE评分相关。当将MMSE分为≤27分和>27分两组时,多因素分析显示CAD的存在、脑血管事件史和DM与MMSE≤27相关。MMSE与心血管事件发生率之间无关联。
患有CAD、中风、TIA或DM的PAD患者的认知功能比没有这些因素的患者更差。没有证据表明认知功能会影响心血管结局。