Impact of coronary interventions on dementia diagnosis by race: Insights from a multi-hospital heart-brain registry

Background Racial and ethnic disparities have been reported with coronary artery disease as well as dementia and Alzheimer's disease (AD) related diagnoses. Objective To investigate the disparities concerning coronary interventions and the incidence of non-vascular and AD-related dementia diagnoses within a multi-site healthcare network. Methods Utilizing the EMR-acquired Heart-Brain registry in a multi-site healthcare network in Western Pennsylvania, we analyzed patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) between 2010 and 2020. We assessed the incidence of ‘likely’ non-vascular dementia, including AD-related diagnosis, over a median follow-up of six years. Baseline covariates were summarized using means and medians. Multivariable adjusted Cox regression hazard ratios (HR 95% CI) were used to examine the association between incident ‘non-vascular dementia and AD-related diagnosis with the type of coronary intervention, stratified by self-reported race. Results Among 47,210 patients, 71.6% (n = 33,822) underwent PCI and 28.4% (n = 13,388) underwent CABG. Overall, the risk of likely non-vascular dementia diagnosis was higher among Black patients (HR = 1.26 1.02–1.56; p = 0.035). In stratified analysis by procedure, Black patients with CABG history had greater risk of non-vascular dementia (HR = 1.85, 95% CI 1.29–2.66; p = 0.020), and AD related diagnosis (HR = 1.73, 95% CI 1.16–2.58; p = 0.007); than White patients. Conclusions Black patients who undergo CABG may be at a higher risk of non-vascular dementia incidence. More research is needed to evaluate the mechanisms of this finding and develop precise risk mitigation strategies to prevent dementia risk.