The independent impact of dementia in patients undergoing percutaneous coronary intervention for acute myocardial infarction

Background: Although age and frailty are associated with worse prognoses for patients who undergo percutaneous coronary intervention (PCI), little is known regarding the independent impact of dementia. Hypothesis: The aim of this study was to evaluate the association between dementia and outcomes for patients with acute myocardial infarction (AMI). Methods: Consecutive patients with ST-elevation or non-ST elevation MI who had undergone PCI as part of our AMI registry were included in this study. We compared outcomes within the 1-year period of their PCI, including death and major adverse cardiac events (MACE) and corrected for confounders using Cox regression. Results: Of 28 274 patients, 9167 patients who had undergone PCI for AMI were included in this study, 250 with dementia; Mean age (77.4 ± 9.4 in the dementia group vs. 63.6 ± 12.7 in the control), female gender (32.4 vs. 24.2%, p =.003), diabetes mellitus (54.0 vs. 42.4%, p <.001) and chronic kidney disease (44.4 vs. 19.3%, p <.001) were higher. At 12 months, unadjusted rates of death (25.5 vs. 9.8%, p <.001) and MACE (33.8 vs. 17.6%, p <.001) were higher for patients with dementia. After standardizing for confounding variables, dementia remained an independent risk factor for death (HR 1.90; CI 1.37–2.65; p <.001) and MACE (HR 1.73; CI 1.30–2.31; p <.001), as well as in propensity score matched analysis (HR 1.54; CI: 1.03–2.28; p <.001 and HR 1.49; CI: 1.09–2.02; p <.001, respectively). Conclusions: Dementia is an independent predictor of worse outcomes in patients undergoing PCI for AMI. Future intervention and specialized healthcare measures to mitigate this risk is warranted.