Cardiovascular and Lifestyle Risk Factors and Cognitive Function in Patients With Stable Coronary Heart Disease

Abstract

Background Vascular risk factors have been associated with differences in cognitive performance in epidemiological studies, but evidence in patients with coronary heart disease is more limited. Methods and Results The Montreal Cognitive Assessment score obtained 3.2±0.37 years after randomization to darapladib, a reversible inhibitor of lipoprotein phospholipase A2 or placebo was evaluated for 10 634 patients with coronary heart disease from 38 countries in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial. The Montreal Cognitive Assessment scores for darapladib and placebo groups were similar (mean±SD, 25.3±3.84 versus 25.4±3.73, respectively; P=0.27) and the adjusted odds ratio (OR) for mild cognitive impairment (Montreal Cognitive Assessment score 8 years/trade school versus college/university, OR, 1.38 [1.25–1.52] and geographic grouping). Cardiovascular risk factors independently associated with cognitive impairment were history of stroke (OR, 1.43 [1.20–1.71]); <2.5 hours of moderate or vigorous intensity exercise/week (OR, 1.19 [1.04–1.37]); high‐density lipoprotein cholesterol <1.16 mmol/L (OR, 1.19 [1.04–1.37]); diabetes mellitus requiring treatment (OR, yes versus no: 1.15 [1.05–1.26]); and history of hypertension (OR, 1.12 [1.02–1.23]). Conclusions In patients with stable coronary heart disease, cognitive performance was associated with modifiable cardiovascular risk factors, educational level, and global region, but was not influenced by darapladib. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00799903.

Keywords

• cognitive impairment
• coronary heart disease
• Montreal Cognitive Assessment
• risk factor