Roy Satyajeet, Hyman Daniel, Ayyala Srinivas, Bakhshi Aditya, Kim Sang Hoon, Anoruo Nancy, Weinstock Joshua, Balogun Ayobamidele, D'Souza Michelle, Filatova Nika, Penabad Jesus, Shah Pratik, Perez Christopher, Mehta Anita, Hunter Krystal
Department of Medicine, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, NJ, USA.
Department of Medicine, University of Massachusetts Medical School-UMASS Memorial Medical Center, Worcester, MA, USA.
J Clin Med Res. 2020 Apr;12(4):255-265. doi: 10.14740/jocmr4144. Epub 2020 Mar 30.
Cardiovascular diseases are the leading cause of death in the USA. Statin therapy reduces cardiovascular events significantly. Cognitive impairment has been reported with statin therapy but there is a lack of consensus. We analyzed the cognitive functions of adult patients who were on moderate-intensity statin therapy (MIST) or high-intensity statin therapy (HIST).
A total of 213 patients underwent cognitive assessment testing. Cognitive function scores were correlated with the durations of statin therapy, age, and level of education by using Pearson correlation. Independent -test was used to compare the mean cognitive function score to the gender, race, type of statin therapy, and comorbid conditions.
Mean age of all the patients was 55.4 years. Majority of the patients (66.2%) were on MIST while the rest (33.8%) were on HIST. Cognitive impairment was observed in 17.8% of the studied patients. A total of 41.7% of the patients in the HIST group and 5.7% in the MIST group had cognitive impairment (P < 0.001). There was no correlation between cognitive function score and age (r = -0.106), weakly positive correlation between the level of education and cognitive function score (r = 0.252), and weakly negative correlation between the duration of statin therapy and cognitive function score (r = -0.283). In the group of patients on HIST with cognitive impairment, the proportion of patients on atorvastatin 40 - 80 mg was significantly higher than the proportion of patients on rosuvastatin 20 - 40 mg (66.7% vs. 33.3%; P < 0.05). In the group of patients on MIST with cognitive impairment, atorvastatin 10 - 20 mg was the most commonly used statin therapy (50%), followed by rosuvastatin 10 mg (25%), simvastatin 20 - 40 mg (12.5%) and pravastatin 40 - 80 mg (12.5%).
We found a significantly higher association of cognitive impairment in patients who were on MIST or HIST compared to the general population. We found no correlation between cognitive function score and age, weakly positive correlation between the level of education and cognitive function score, and weakly negative correlation between the duration of statin therapy and cognitive function score. HIST was associated with a higher frequency of cognitive impairment compared to the MIST.
心血管疾病是美国主要的死亡原因。他汀类药物治疗可显著降低心血管事件的发生。已有报道称他汀类药物治疗会导致认知功能障碍，但目前尚无定论。我们分析了接受中等强度他汀类药物治疗（MIST）或高强度他汀类药物治疗（HIST）的成年患者的认知功能。
共有213例患者接受了认知评估测试。通过Pearson相关性分析将认知功能评分与他汀类药物治疗时长、年龄和教育程度进行关联。采用独立样本t检验比较平均认知功能评分在性别、种族、他汀类药物治疗类型和合并症方面的差异。
所有患者的平均年龄为55.4岁。大多数患者（66.2%）接受MIST治疗，其余患者（33.8%）接受HIST治疗。在17.8%的研究患者中观察到认知功能障碍。HIST组中共有41.7%的患者出现认知功能障碍，MIST组为5.7%（P<0.001）。认知功能评分与年龄之间无相关性（r=-0.106），教育程度与认知功能评分之间呈弱正相关（r=0.252），他汀类药物治疗时长与认知功能评分之间呈弱负相关（r=-0.283）。在出现认知功能障碍的HIST组患者中，服用40 - 80 mg阿托伐他汀的患者比例显著高于服用20 - 40 mg瑞舒伐他汀的患者比例（66.7%对33.3%；P<0.05）。在出现认知功能障碍的MIST组患者中，最常用的他汀类药物治疗为10 - 20 mg阿托伐他汀（50%），其次是10 mg瑞舒伐他汀（25%）、20 - 40 mg辛伐他汀（12.5%）和40 - 80 mg普伐他汀（12.5%）。
我们发现与普通人群相比，接受MIST或HIST治疗的患者出现认知功能障碍的相关性显著更高。我们发现认知功能评分与年龄之间无相关性，教育程度与认知功能评分之间呈弱正相关，他汀类药物治疗时长与认知功能评分之间呈弱负相关。与MIST相比，HIST与更高频率的认知功能障碍相关。
