Novel Indices of Cognitive Impairment and Incident Cardiovascular Outcomes in the REWIND Trial.
J Clin Endocrinol Metab
; 107(8): e3448-e3454, 2022 07 14.
Article
em En
| MEDLINE
| ID: mdl-35446415
ABSTRACT
CONTEXT Low cognitive scores are risk factors for cardiovascular outcomes. Whether this relationship is stronger using novel cognitive indices is unknown. METHODS:
Participants in the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial who completed both the Montreal Cognitive Assessment (MoCA) score and Digit Substitution Test (DSST) at baseline (Nâ =â 8772) were included. These scores were used to identify participants with baseline substantive cognitive impairment (SCI), defined as a baseline score on either the MoCA or DSSTâ ≥â 1.5 SD below either score's country-specific mean, or SCI-GM, which was based on a composite index of both scores calculated as their geometric mean (GM), and defined as a score that wasâ ≥â 1.5 SD below their country's average GM. Relationships between these measures and incident major adverse cardiovascular events (MACE), and either stroke or death were analyzed.RESULTS:
Compared with 7867 (89.7%) unaffected participants, the 905 (10.3%) participants with baseline SCI had a higher incidence of MACE (unadjusted hazard ratio [HR] 1.34; 95% CI 1.11, 1.62; Pâ =â 0.003), and stroke or death (unadjusted HR 1.60; 95% CI 1.33, 1.91; Pâ <â 0.001). Stronger relationships were noted for SCI-GM and MACE (unadjusted HR 1.61; 95% CI 1.28, 2.01; Pâ <â 0.001), and stroke or death (unadjusted HR 1.85; 95% CI 1.50, 2.30; Pâ <â 0.001). For SCI-GM but not SCI, all these relationships remained significant in models that adjusted for up to 10 SCI risk factors.CONCLUSION:
Country-standardized SCI-GM was a strong independent predictor of cardiovascular events in people with type 2 diabetes in the REWIND trial.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
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Acidente Vascular Cerebral
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Diabetes Mellitus Tipo 2
/
Disfunção Cognitiva
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Israel