title: Angina pectoris severity among coronary heart disease patients is associated with subsequent cognitive impairment.
abstract: BACKGROUND
  The relationship between coronary heart disease (CHD) and cognitive function is not completely elucidated. We examined the association between severity of angina pectoris (AP) in mid-life and subsequent cognitive impairment among CHD patients.
  
  
  METHODS
  Severity of AP according to the Canadian Cardiovascular Society angina classification was assessed in a subgroup of people with chronic CHD, who previously participated in a secondary prevention trial. Cognitive performance was evaluated 15±3 years later, using a validated set of computerized cognitive tests (Neurotrax Computerized Cognitive Battery; computing index scores summarizing performance in each cognitive domain and a global cognitive score). We compared the risk of cognitive deficits in participants with AP class >2 to those with AP≤2, adjusting for vascular risk factors, common carotid-intima media thickness (CC-IMT), and presence of carotid plaques.
  
  
  RESULTS
  Among 535 participants (mean age at baseline 57.9±6.6 y; 95% males), AP class >2 was associated with subsequent poorer performance on tests of memory and attention compared to those with AP class ≤2 (β=-4.3±1.8; P=0.016 and β=-3.6±1.7; P=0.029, respectively) and with a higher risk of having impairment in these domains [odds ratio (95% confidence interval)=1.83 (1.11-3.02); P=0.019 and 2.36 (1.34-4.16); P=0.003, for memory and attention, respectively]. These results were similar after controlling for vascular risk factors; however, the association of AP with memory domain attenuated after adjustment for CC-IMT or presence of carotid plaques.
  
  
  CONCLUSIONS
  In people with preexisting CHD, severity of AP is associated with late-life poorer cognitive performance, independent of other vascular risk factors.
authors.affiliation: *Department of Neurology, Boston University School of Medicine, Boston, MA †Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv ‡The Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Galit
authors.initials: G
authors.lastname: Weinstein
authors.forename: Uri
authors.initials: U
authors.lastname: Goldbourt
authors.forename: David
authors.initials: D
authors.lastname: Tanne
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index