Key result
Smoking is linked to ~3-fold higher odds of cognitive impairment in coronary heart disease.
Why the study?
The reported prevalence and risk factors of cognitive impairment in CHD vary substantially across measurement approaches and time points.
Meta-Analysis (n=9,207)
Cognitive impairment is highly prevalent (36.6%) in patients with coronary heart disease, with older age, smoking, prior stroke, diabetes, depression, and anxiety serving as significant predictors.
Answers are grounded in this paper and cite their sources.
May warrant cognitive screening in CHD patients with modifiable risks; meta-analysis supports associations but leaves practice change open pending prospective data.
Background The prevalence and risk factors of cognitive impairment in patients with coronary atherosclerotic heart disease (CHD) vary substantially depending on the measurement approaches and time points adopted. Through a meta-analysis, we aim to clarify the prevalence and risk factors of cognitive impairment in CHD patients, thereby providing a reference for the implementation of targeted interventions. Methods Computerized searches were conducted across 9 databases, including the China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang Database, China Biomedical Literature Database (CBM), PubMed, Cochrane Library, Embase, Medline, and Web of Science, to retrieve literature on risk factors for cognitive impairment in patients with coronary heart disease (CHD). Searches were run from database inception to July 2025. After literature screening, data extraction and quality assessment, a meta-analysis was performed using Stata 16.0 and RevMan 5.4 software. Results A total of 22 studies were included, involving 9,207 patients. The prevalence of cognitive impairment in CHD patients was 36.6% [95% CI (27.6%–45.7%)]. Meta-analysis and systematic review revealed that age [OR: 1.10 (1.04–1.17), P = 0.001], history of stroke [OR: 1.99 (1.09–3.62), P = 0.02], smoking [OR: 3.05 (2.00–4.66), P < 0.001], diabetes [OR: 2.31 (1.22–4.36), P = 0.01], depression [OR: 1.67 (1.24–2.26), P < 0.001], and anxiety [OR: 2.03 (1.54–2.69), P < 0.001] were significant risk factors for cognitive impairment in CHD patients. In contrast, no significant correlations were observed between cognitive impairment and education level, hypertension, systolic blood pressure, or HDL-C. Conclusion Cognitive impairment is notably prevalent among patients with coronary heart disease (CHD). Specifically, elderly patients, smokers, those with a history of stroke or diabetes, and individuals with negative emotions such as anxiety and depression face a particularly high risk of developing cognitive impairment. Healthcare professionals should identify these high-risk groups as early as possible, conduct dynamic assessments of changes in their cognitive function, and implement targeted interventions to effectively prevent the onset of cognitive impairment. Systematic Review Registration https://www.crd.york.ac.uk/prospero/ , identifier (CRD420251106812).
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Han et al. (2026) conducted a meta-analysis in Coronary heart disease (CHD) (n=9,207). Smoking vs. Non-smokers was evaluated on Risk of cognitive impairment (OR 3.05, 95% CI 2.00-4.66, p=<0.001). Among patients with coronary heart disease, the overall prevalence of cognitive impairment was 36.6%, and smoking was identified as a significant risk factor increasing this risk (OR 3.05).
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