摘要
Background Cognitive impairment (CI) increases cardiac mortality among very elderly patients. Percutaneous coronary intervention (PCI) for ischemic heart disease (IHD) patients is considered a favorable strategy for decreasing cardiac mortality. Here, we investigated the influence of CI on cardiac mortality after PCI in very elderly patients. Methods We performed a retrospective observational analysis of patients who received PCI between 2012 and 2014 at the South Miyagi Medical Center, Japan. IHD patients over 80 years old who underwent the Mini-Mental State Examination for CI screening during hospitalization and/or who had been diagnosed with CI were included. Participants were divided into CI and non-CI groups, and cardiac mortality and incidence of adverse cardiac events in a 3-year follow-up period were compared between groups. Statistical analyses were performed using the t-test,χ^2 test, and multivariable Cox regression analysis, with major comorbid illness and conventional cardiac risk factors as confounders. Results Of 565 patients, 95 were included (41 CI, 54 non-CI). Cardiac mortality during the follow-up period was significantly higher in the CI group (36%) compared with the non-CI group (13%)(OR = 4.3, 95% CI: 1.56–11.82, P < 0.05). CI was an independent cardiac prognostic factor after PCI and, for CI patients, living only with a CI partner was an independent predictor of cardiac death within three years. Conclusions CI significantly affected cardiac prognosis after PCI in very elderly patients, particularly those living with a CI partner. To improve patients’ prognoses, social background should be considered alongside conventional medical measures.
Background Cognitive impairment(CI) increases cardiac mortality among very elderly patients. Percutaneous coronary intervention(PCI) for ischemic heart disease(IHD) patients is considered a favorable strategy for decreasing cardiac mortality. Here, we investigated the influence of CI on cardiac mortality after PCI in very elderly patients. Methods We performed a retrospective observational analysis of patients who received PCI between 2012 and 2014 at the South Miyagi Medical Center, Japan. IHD patients over 80 years old who underwent the Mini-Mental State Examination for CI screening during hospitalization and/or who had been diagnosed with CI were included. Participants were divided into CI and non-CI groups, and cardiac mortality and incidence of adverse cardiac events in a 3-year follow-up period were compared between groups. Statistical analyses were performed using the t-test, χ~2 test, and multivariable Cox regression analysis, with major comorbid illness and conventional cardiac risk factors as confounders. Results Of 565 patients, 95 were included(41 CI, 54 non-CI). Cardiac mortality during the follow-up period was significantly higher in the CI group(36%) compared with the non-CI group(13%)(OR = 4.3, 95% CI: 1.56–11.82, P < 0.05). CI was an independent cardiac prognostic factor after PCI and, for CI patients, living only with a CI partner was an independent predictor of cardiac death within three years. Conclusions CI significantly affected cardiac prognosis after PCI in very elderly patients, particularly those living with a CI partner. To improve patients’ prognoses, social background should be considered alongside conventional medical measures.
