ArticlemedRxiv : the preprint server for health sciences2026
Association of cognitive impairment with statin use in coronary artery disease across APO (ε) genotypes in AllofUS.
Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCoronary artery disease (CAD) and Impaired Cognitive (IC) disease share sociodemographic, genetic, and clinical factors, but the association of IC with statin use in CAD remains unclear.
objectivesTo determine the association between IC and statin use in CAD based on APO (ε) genotype, sex, and lipid levels. DESIGN SETTING AND
participantsWe performed a retrospective study of AllofUS (AoU) participants with CAD (age≥60 yrs) enrolled from 2017 to 2023. We defined CAD as having a history of angina/myocardial infarction/chronic ischemic heart disease or having percutaneous coronary intervention/CABG, and IC defined as mild cognitive impairment or all-cause dementia, using ICD/SNOMED codes. MEASURES: We assessed the association between IC and statin use using logistic regression analysis, while adjusting for clinical factors, sociodemographics, and APO (ε) genotypes before and after propensity score matching. We further performed stratified analysis by sex, and APO (ε) genotypes. We finally assessed the association between IC and statin users, based magnitude on the change in lipid levels before CAD and after IC (TC-Total cholesterol, LDL - low density lipoprotein, HDL- High Density Lipoprotein). Significance was defined at p < 0.05.
resultsThe cohort included 22,089 participants with CAD and 1343 with IC. Thirty-nine percent of participants were females, 77% were European, 13% were African American, and 9% were of Admixed American ancestry. The proportion of IC was higher (
conclusionIn the AllofUS cohort, IC was significantly associated with statin use in CAD participants. We observed the strongest association in the APO ε3ε3 group, among females, and with a greater increase in HDL levels in statin users.
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