Novel Indices of Cognitive Impairment and Incident Cardiovascular Outcomes in the REWIND Trial

Primer Autor
Gerstein, Hertzel C.
Co-autores
Cukierman-Yaffe, Tali
Basile, Jan
Bethel, M. Angelyn
Cardona-Munoz, Ernesto G.
Conget, Ignacio
Dagenais, Gilles
Franek, Edward
Hall, Stephanie
Hancu, Nicolae
Jansky, Petr
Lakshmanan, Mark
Lanas, Fernando
Leiter, Lawrence A.
Lopez-Jaramillo, Patricio
Pirags, Valdis
Pogosova, Nana
Probstfield, Jeffrey
Rao-Melacini, Purnima
Ramasundarahettige, Chinthanie
Raubenheimer, Peter J.
Riddle, Matthew C.
Ryden, Lars
Shaw, Jonathan E.
Sheu, Wayne H-H
Temelkova-Kurktschiev, Theodora
Título
Novel Indices of Cognitive Impairment and Incident Cardiovascular Outcomes in the REWIND Trial
Editorial
ENDOCRINE SOC
Revista
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Lenguaje
en
Resumen
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 (N = 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 DSST >= 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 was >= 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, P = 0.003), and stroke or death (unadjusted HR 1.60, 95% CI 1.33, 1.91, P < 0.001). Stronger relationships were noted for SCI-GM and MACE (unadjusted HR 1.61, 95% CI 1.28, 2.01, P < 0.001), and stroke or death (unadjusted HR 1.85, 95% CI 1.50, 2.30, P < 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.
Tipo de Recurso
artículo original
doi
10.1210/clinem/dgac200
Formato Recurso
PDF
Palabras Claves
Cognitive impairment
Risk factor
Composite outcome
Geometric mean
Cardiovascular events
MACE
Stroke
Death
HOC EPIDEMIOLOGIC ANALYSIS
DIABETES-MELLITUS
INSULIN
DISEASE
HYPOGLYCEMIA
DYSFUNCTION
MANAGEMENT
GUIDELINE
EVENTS
PEOPLE
Ubicación del archivo
http://dx.doi.org/10.1210/clinem/dgac200
Categoría OCDE
Endocrinología y Metabolismo
Materias
Deterioro cognitivo
Factor de riesgo
Resultado compuesto
Media geométrica
Eventos cardiovasculares
MACE
Apoplejía
Muerte
ANÁLISIS EPIDEMIOLÓGICO HOC
DIABETES-MELLITUS
INSULINA
ENFERMEDAD
HIPOGLUCEMIA
DISFUNCIÓN
MANEJO
GUÍA
EVENTOS
PERSONAS
Disciplinas de la OCDE
Sistema Cardiovascular y Cardiaco
Endocrinología y Metabolismo (Incluye Diabetes, Hormonas)
Neurología Clínica
Título de la cita (Recomendado-único)
Novel Indices of Cognitive Impairment and Incident Cardiovascular Outcomes in the REWIND Trial
Página de inicio (Recomendado-único)
E3448
Página final (Recomendado-único)
E3454
Identificador del recurso (Mandatado-único)
artículo original
Versión del recurso (Recomendado-único)
version publicada
Condición de la licencia (Recomendado-repetible)
0
Derechos de acceso
acceso abierto
Access Rights
acceso abierto
Id de Web of Science
WOS:000788248100001
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