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Abstract 18325: Changes in Cognition and Lipid-lowering Therapy After the Acute Coronary Syndrome: Results From TRACE-CORE


 Introduction:
 Lipid-lowering therapies (LLT) are a key component of treatment in acute coronary syndrome (ACS). Some studies have found an adverse effect of LLTs on cognition yet evidence is inconsistent. We describe 12-month trajectories of cognition among ACS survivors in relation to post-discharge LLT use.
 
 
 Methods:
 Adult patients (n=2187) hospitalized for ACS in Georgia and Massachusetts enrolled in Transitions, Risks, and Actions in Coronary Events: Center for Outcomes Research and Education (TRACE-CORE) and underwent serial cognitive assessments from index hospitalization through 12 months via the Telephone Interview for Cognitive Status (TICS; range: 0-41; higher scores indicate better cognitive function). The primary outcome was change in TICS and unadjusted between-group comparisons were conducted using the two-sample T-test at 1, 3, 6, and 12 months. A multivariable linear model was constructed to examine the between-group comparison adjusted for baseline demographics, cardiovascular and in-hospital risk factors, and other comorbidities.
 
 
 Results:
 Participants were 67% male, 80% non-Hispanic white, and aged 61.4±11.3 years. Ninety-two percent were discharged on LLT. At 1 month follow-up (n=1527), patients improved on subsequent cognitive testing regardless of treatment with LLTs; mean TICS improvement was 1.0 for patients on LLT vs. 1.6 for those untreated (p=0.11). In adjusted models, change in TICS did not differ by LLT use (β= -0.41; 95% CI:-1.15, 0.33). Interval changes at 3, 6, and 12 months did not differ by LLT use, with complete follow-up cognitive testing available for 1345 patients (see figure).
 
 
 Conclusions:
 The prescription of LLT is not associated with the trajectory of cognitive function after hospital discharge for ACS. Despite concerns about the potential cognitive impact of lipid-lowering drugs raised by previous studies, our findings do not support an adverse impact on cognition among ACS patients treated with LLT.
 
 
 
