Wang Qing, Xu Shihan, Liu Fenglan, Liu Yanfei, Liu Yue, Xu Fengqin
The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Front Cardiovasc Med. 2023 Jan 16;9:1107544. doi: 10.3389/fcvm.2022.1107544. eCollection 2022.
Ischemic heart disease and degenerative encephalopathy are two main sources of disease burden for the global elderly population. Coronary heart disease (CHD) and cognitive impairment, as representative diseases, are prevalent and serious illnesses in the elderly. According to recent research, patients with CHD are more likely to experience cognitive impairment and their cognitive ability declines more quickly. Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with CHD is more limited. Inextricably linked between the heart and the brain. Considering the unique characteristics of recurrent cognitive impairment in patients with CHD, we will further study the related risk factors. We tried to investigate the potential predictors of cognitive impairment in patients with CHD through a prospective, cross-sectional study.
The cross-sectional study design will recruit 378 patients with CHD (≥65 years) from Xiyuan Hospital of China Academy of Chinese Medical Sciences. The subjects' cognitive function is evaluated with MoCA scale, and they are divided into cognitive impairment group and normal cognitive function group according to the score results. Demographic data, disease characteristics (results of coronary CT/ angiography, number of stents implanted, status of diseased vessels), laboratory tests (biochemistry, coagulation, serum iron levels, pulse wave velocity), metabolites (blood samples and intestinal metabolites), and lifestyle (smoking, alcohol consumption, sleep, physical activity) will be assessed as outcome indicators. Compare the two groups and the correlation analysis will be performed on the development of mild cognitive impairment. Mann-Whitney U or X test was selected to describe and evaluate the variation, and logistics regression analysis was employed to fit the prediction model. After that, do the calibration curve and decision curve to evaluate the model. The prediction model will be validated by a validation set.
To explore the risk factors related to mild cognitive impairment (MCI) in patients with CHD, a new predictive model is established, which can achieve advanced intervention in the occurrence of MCI after CHD. Owing to its cross-sectional study design, the study has some limitations, but it will be further studied by increasing the observation period, adding follow-up data collection or prospective cohort study. The study has been registered with the China Clinical Trials Registry (ChiCTR2200063255) to conduct clinical trials.
缺血性心脏病和退行性脑病是全球老年人群疾病负担的两个主要来源。冠心病（CHD）和认知障碍作为代表性疾病，在老年人中普遍且严重。根据最近的研究，冠心病患者更容易出现认知障碍，且其认知能力下降更快。在流行病学研究中，血管危险因素与认知表现的差异有关，但在冠心病患者中的证据更为有限。心脏和大脑之间存在着千丝万缕的联系。考虑到冠心病患者反复出现认知障碍的独特特征，我们将进一步研究相关危险因素。我们试图通过一项前瞻性横断面研究来调查冠心病患者认知障碍的潜在预测因素。
横断面研究设计将从中国中医科学院西苑医院招募378名冠心病患者（≥65岁）。用蒙特利尔认知评估量表（MoCA）评估受试者的认知功能，并根据评分结果将其分为认知障碍组和认知功能正常组。人口统计学数据、疾病特征（冠状动脉CT/血管造影结果、植入支架数量、病变血管状况）、实验室检查（生化、凝血、血清铁水平、脉搏波速度）、代谢产物（血液样本和肠道代谢产物）以及生活方式（吸烟、饮酒、睡眠、体育活动）将作为结局指标进行评估。比较两组，并对轻度认知障碍的发生进行相关性分析。选择曼-惠特尼U检验或X检验来描述和评估差异，并采用逻辑回归分析来拟合预测模型。之后，绘制校准曲线和决策曲线以评估模型。预测模型将通过验证集进行验证。
为探索冠心病患者轻度认知障碍（MCI）的相关危险因素，建立了一种新的预测模型，该模型可对冠心病后MCI的发生进行早期干预。由于其横断面研究设计，本研究存在一些局限性，但将通过延长观察期、增加随访数据收集或进行前瞻性队列研究来进一步研究。本研究已在中国临床试验注册中心注册（ChiCTR2200063255）以开展临床试验。
