Cognitive dysfunction status and risk prediction of patients with coronary heart disease / 中国实用护理杂志

ABSTRACT

Objective:To understand the current situation of cognitive dysfunction in patients with coronary heart disease, and explore the risk prediction model of the onset of cognitive dysfunction in patients with coronary heart disease.Methods:A total of 448 patients with coronary heart disease admitted to the North China University of Science and Technology Affiliated Hospital from January 2019 to June 2020 were prospectively selected as study subjects. Patients with coronary heart disease were divided into the cognitive dysfunction group ( n=185) and the normal cognitive function group ( n=263) according to whether they were accompanied by cognitive dysfunction. Demographic characteristics, cognitive function, disease history, blood pressure, blood glucose, blood lipid and vascular lesions were compared between the two groups. Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function. Logistic regression was used to analyze the risk factors of cognitive dysfunction in coronary heart disease patients, and the prediction model of the above risk factors was constructed. The value of the prediction model was evaluated by C-index and cilibration curve. Results:The language, abstraction, visual space and execution, delayed memory and total scores of the cognitive dysfunction group were 1.81 ± 0.59, 1.12 ± 0.33, 3.01 ± 0.90, 2.61 ± 0.79 and 22.32 ± 1.70, respectively, which were lower than those of the normal cognitive function group (2.68 ± 0.47, 1.82 ± 0.38, 4.54 ± 0.50, 4.77 ± 0.42, 27.67 ± 0.76), and the differences were statistically significant ( t values were 17.39-40.00, all P<0.05). The age, fasting blood glucose, systolic blood pressure, proportion of alcohol drinking, proportion of diabetes mellitus in the cognitive dysfunction group were (62.86 ± 5.21) years, (6.19 ± 0.89) mmol/L, (144.00 ± 17.16) mmHg (1 mmHg=0.133 kPa), 36.76% (68/185), 16.22% (30/185), respectively, which were higher than (58.77 ± 5.63) years, (5.46 ± 0.95) mmol/L, (133.74 ± 15.90) mmHg, 27.38% (72/263), 6.84% (18/263) in the normal cognitive function group, the differences were statistically significant ( t=7.81, 8.25, 6.42, χ2=4.45, 9.97, all P<0.05). The rates of single vessel, double vessel and three vessel lesions in the cognitive dysfunction group were 49.73% (92/185), 27.03% (50/185) and 23.24% (43/185), respectively, and those in normal cognitive function group were 46.39% (122/263), 39.92% (105/263) and 13.69% (36/263), respectively ( χ2=11.10, P<0.05) . Logistic regression analysis showed that age, fasting blood glucose, systolic blood pressure and number of vascular lesions were independent risk factors for coronary heart disease patients with cognitive impairment ( OR values were 1.038-2.216, all P<0.05). The correction curve of the prediction model composed of age, fasting blood glucose, systolic blood pressure and number of vascular lesions was in good agreement with the ideal curve, and the C-index of the model was 0.807 for the diagnosis of cognitive dysfunction in patients with coronary heart disease. Conclusions:The cognitive dysfunction of patients with coronary heart disease is mainly manifested in language, abstraction, visual space and execution and delayed memory. The prediction model composed of age, fasting blood glucose, systolic blood pressure and number of vascular lesions has a certain degree of discrimination and accuracy for patients with coronary heart disease complicated by cognitive dysfunction, and can be used for the screening of coronary heart disease complicated by cognitive dysfunction.