ASSOCIATION BETWEEN DEMENTIA AND SHORT-TERM OUTCOMES OF ACUTE CORONARY SYNDROME IN VERY ELDERLY PATIENTS
Main Article Content
Abstract
Background: Dementia in very elderly patients with acute coronary syndrome (ACS) is becoming increasingly prevalent and concerning because of its adverse impact on both short- and long-term prognosis. However, to date, there have been limited studies and data regarding this issue..
Objectives: To investigate the association between cognitive impairment and short-term clinical outcomes in very elderly patients with ACS.
Methods: This prospective cohort study enrolled very elderly patients (≥80 years) hospitalized for ACS at the Department of Interventional Emergency Cardiology, Thong Nhat Hospital and the Department of Interventional Cardiology, University Medical Center Ho Chi Minh City. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined as an MMSE score <20. Cox proportional hazards regression analysis was performed to evaluate the association between cognitive impairment and short-term outcomes.
Results: A total of 212 very elderly patients with ACS were included, of whom 44% had cognitive impairment. Patients with cognitive impairment had a significantly higher 3-month mortality risk compared with those without cognitive impairment (HR = 3.7; 95% CI: 1.5–9.5; p = 0.006). Cognitive impairment was also associated with an increased risk of all-cause rehospitalization and cardiovascular rehospitalization, with hazard ratios of 2.7 (95% CI: 1.6–4.4) and 2.6 (95% CI: 1.5–4.3), respectively. However, these associations lost statistical significance after adjustment for confounding factors in the multivariable models. No significant difference in invasive coronary revascularization rates was observed between the two groups.
Conclusions: The prevalence of cognitive impairment among very elderly patients with ACS in this study was 44%. Cognitive impairment was associated with a trend toward increased risks of short-term mortality and rehospitalization, suggesting that it may represent an unfavorable prognostic factor that should be considered in the comprehensive assessment and management of very elderly patients with ACS.
Keywords
Dementia, very elderly patient, acute coronary syndrome
Article Details
References
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