Angina pectoris severity among coronary heart disease patients is associated with subsequent cognitive impairment

Alzheimer Dis Assoc Disord. Jan-Mar 2015;29(1):6-11. doi: 10.1097/WAD.0000000000000038.


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.

Result: 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Angina Pectoris / complications*
  • Angina Pectoris / diagnosis*
  • Angina Pectoris / psychology
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology*
  • Cognition Disorders / psychology
  • Coronary Disease / complications*
  • Coronary Disease / diagnosis*
  • Coronary Disease / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index