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心肌梗死后心血管疾病患者的认知障碍:前瞻性临床研究

Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study.

作者信息

Kasprzak Dominika, Kaczmarek-Majer Katarzyna, Rzeźniczak Janusz, Klamecka-Pohl Katarzyna, Ganowicz-Kaatz Teresa, Słomczyński Marek, Budzianowski Jan, Pieszko Konrad, Hiczkiewicz Jarosław, Tykarski Andrzej, Burchardt Paweł

机构信息

Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland.

Stochastic Methods Department, System Research Institute, Polish Academy of Sciences, 01-447 Warsaw, Poland.

出版信息

J Clin Med. 2023 Jul 27;12(15):4954. doi: 10.3390/jcm12154954.

Abstract

(1) Background: Assessment of cognitive function is not routine in cardiac patients, and knowledge on the subject remains limited. The aim of this study was to assess post-myocardial infarction (MI) cognitive functioning in order to determine the frequency of cognitive impairment (CI) and to identify factors that may influence it. (2) Methods: A prospective study included 468 patients hospitalized for MI. Participants were assessed twice: during the first hospitalization and 6 months later. The Mini-Mental State Examination was used to assess the occurrence of CI. (3) Results: Cognitive dysfunction based on the MMSE was found in 37% (N-174) of patients during the first hospitalization. After 6 months, the prevalence of deficits decreased significantly to 25% (N-91) ( < 0.001). Patients with CI significantly differed from those without peri-infarction deficits in the GFR, BNP, ejection fraction and SYNTAX score, while after 6 months, significant differences were observed in LDL and HCT levels. There was a high prevalence of non-cognitive mental disorders among post-MI patients. (4) Conclusions: There is a high prevalence of CI and other non-cognitive mental disorders, such as depression, sleep disorders and a tendency to aggression, among post-MI patients. The analysis of the collected material indicates a significant impact of worse cardiac function expressed as EF and BNP, greater severity of coronary atherosclerosis expressed by SYNTAX results, and red blood cell parameters and LDL levels on the occurrence of CI in the post-MI patient population.

摘要

(1) 背景:对心脏病患者认知功能的评估并非常规操作,对此主题的了解仍然有限。本研究的目的是评估心肌梗死后(MI)的认知功能,以确定认知障碍(CI)的发生率,并识别可能影响其的因素。(2) 方法:一项前瞻性研究纳入了468例因心肌梗死住院的患者。参与者接受了两次评估:首次住院期间和6个月后。使用简易精神状态检查表来评估认知障碍的发生情况。(3) 结果:在首次住院期间,37%(N = 174)的患者基于简易精神状态检查表存在认知功能障碍。6个月后,缺陷患病率显著下降至25%(N = 91)(P < 0.001)。认知障碍患者与无梗死周围缺陷的患者在肾小球滤过率、脑钠肽、射血分数和SYNTAX评分方面存在显著差异,而6个月后,在低密度脂蛋白和血细胞比容水平上观察到显著差异。心肌梗死后患者中非认知性精神障碍的患病率较高。(4) 结论:心肌梗死后患者中认知障碍和其他非认知性精神障碍,如抑郁、睡眠障碍和攻击倾向的患病率较高。对收集材料的分析表明,以射血分数和脑钠肽表示的较差心脏功能、SYNTAX结果所表示的冠状动脉粥样硬化的更严重程度,以及红细胞参数和低密度脂蛋白水平对心肌梗死后患者群体中认知障碍的发生有显著影响。

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