Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
Stroke-heart syndrome and risk of incident dementia among patients with first-ever ischemic stroke: A territory-wide population-based cohort study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Tsang Christopher T W, Choi Sylvia E, Bucci Tommaso, Lau Alfred C W, Ren Qing-Wen, Huang Jia-Yi, Wu Mei-Zhen, Gu Wen-Li, Guo Ran, Zhang Jing-Nan, Ng Yuen-Ching, Buckley Benjamin J R, Scheitz Jan F, Chan Yap-Hang, Lau Kui-Kai, Tse Hung-Fat, Abdul-Rahim Azmil H, Lip Gregory Y H, Yiu Kai-Hang
Аннотация
INTRODUCTION: The risk of dementia in patients with ischemic stroke and early cardiovascular complications (i.e., stroke-heart syndrome [SHS]) remains underexplored.
METHODS: Patients with first-ever ischemic stroke in Hong Kong between 2005 and 2020 were included. Multivariable Fine-Gray competing risk analysis was performed after 1:1 propensity score matching to evaluate the association between SHS and the risk of dementia.
RESULTS: Of the 130,605 included patients with ischemic stroke, 12,696 (9.7%) patients developed SHS. Patients with SHS had a 19% increased risk of dementia compared to those without SHS at 1 year post-stroke, driven mainly by vascular dementia. This increased risk gradually declined and became non-significant after 3 years post-stroke. Appropriate antithrombotic therapy and comorbidities optimization were associated with a 32% reduced dementia risk in patients with SHS.
DISCUSSION: SHS is associated with an increased risk of incident dementia. Appropriate antithrombotic therapy and comorbidities optimization post-stroke may reduce this heightened risk of cognitive impairment.
HIGHLIGHTS: Association between stroke-heart syndrome (SHS) and dementia was evaluated in a population-based cohort. Development of SHS associated with a 19% increased 1 year risk of dementia. The increased risk of dementia gradually declined with each year of follow-up. Integrated post-stroke management may reduce this heightened risk of cognitive impairment.
METHODS: Patients with first-ever ischemic stroke in Hong Kong between 2005 and 2020 were included. Multivariable Fine-Gray competing risk analysis was performed after 1:1 propensity score matching to evaluate the association between SHS and the risk of dementia.
RESULTS: Of the 130,605 included patients with ischemic stroke, 12,696 (9.7%) patients developed SHS. Patients with SHS had a 19% increased risk of dementia compared to those without SHS at 1 year post-stroke, driven mainly by vascular dementia. This increased risk gradually declined and became non-significant after 3 years post-stroke. Appropriate antithrombotic therapy and comorbidities optimization were associated with a 32% reduced dementia risk in patients with SHS.
DISCUSSION: SHS is associated with an increased risk of incident dementia. Appropriate antithrombotic therapy and comorbidities optimization post-stroke may reduce this heightened risk of cognitive impairment.
HIGHLIGHTS: Association between stroke-heart syndrome (SHS) and dementia was evaluated in a population-based cohort. Development of SHS associated with a 19% increased 1 year risk of dementia. The increased risk of dementia gradually declined with each year of follow-up. Integrated post-stroke management may reduce this heightened risk of cognitive impairment.