Kuźma Elżbieta, Airdrie Jac, Littlejohns Thomas J, Lourida Ilianna, Thompson-Coon Jo, Lang Iain A, Scrobotovici Monica, Thacker Evan L, Fitzpatrick Annette, Kuller Lewis H, Lopez Oscar L, Longstreth William T, Ukoumunne Obioha C, Llewellyn David J
*Institute of Health Research, University of Exeter Medical School, Exeter †School of Psychology, Cardiff University, Cardiff ‡Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK §Department of Health Science, Brigham Young University, Provo, UT Departments of ∥Epidemiology **Neurology, University of Washington, Seattle, WA Departments of ¶Epidemiology #Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA.
Alzheimer Dis Assoc Disord. 2017 Apr-Jun;31(2):120-127. doi: 10.1097/WAD.0000000000000191.
The association between history of coronary artery bypass graft surgery (CABG) and dementia risk remains unclear.
We conducted a prospective cohort analysis using data on 3155 elderly adults free from prevalent dementia from the US population-based Cardiovascular Health Study (CHS) with adjudicated incident all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), and mixed dementia.
In the CHS, the hazard ratio (HR) for all-cause dementia was 1.93 [95% confidence interval (CI), 1.36-2.74] for those with CABG history compared with those with no CABG history after adjustment for potential confounders. Similar HRs were observed for AD (HR=1.71; 95% CI, 0.98-2.98), VaD (HR=1.42; 95% CI, 0.56-3.65), and mixed dementia (HR=2.73; 95% CI, 1.55-4.80). The same pattern of results was observed when these CHS findings were pooled with a prior prospective study, the pooled HRs were 1.96 (95% CI, 1.42-2.69) for all-cause dementia, 1.71 (95% CI, 1.04-2.79) for AD and 2.20 (95% CI, 0.78-6.19) for VaD.
Our results suggest CABG history is associated with long-term dementia risk. Further investigation is warranted to examine the causal mechanisms which may explain this relationship or whether the association reflects differences in coronary artery disease severity.
冠状动脉旁路移植术（CABG）史与痴呆风险之间的关联仍不明确。
我们利用来自美国基于人群的心血管健康研究（CHS）的3155名无痴呆症的老年人的数据进行了一项前瞻性队列分析，这些数据包括经判定的全因性痴呆、阿尔茨海默病（AD）、血管性痴呆（VaD）和混合性痴呆的发病情况。
在CHS中，在对潜在混杂因素进行调整后，有CABG史的患者与无CABG史的患者相比，全因性痴呆的风险比（HR）为1.93[95%置信区间（CI），1.36 - 2.74]。AD（HR = 1.71；95% CI，0.98 - 2.98）、VaD（HR = 1.42；95% CI，0.56 - 3.65）和混合性痴呆（HR = 2.73；95% CI，1.55 - 4.80）的HR值也类似。当将这些CHS研究结果与先前的一项前瞻性研究合并时，观察到了相同的结果模式，全因性痴呆的合并HR为1.96（95% CI，1.42 - 2.69），AD为1.71（95% CI，1.04 - 2.79），VaD为2.20（95% CI，0.78 - 6.19）。
我们的结果表明CABG史与长期痴呆风险相关。有必要进一步研究以探讨可能解释这种关系的因果机制，或者这种关联是否反映了冠状动脉疾病严重程度的差异。
