Affiliations: [a] Department of Polyvascular Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Sciences, Kemerovo, Russian Federation | [b] Director of Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Sciences, Kemerovo, Russian Federation
Correspondence:
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Correspondence to: Olga A. Trubnikova, PhD, Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Sciences, Siberian Branch, Department of Polyvascular Atherosclerosis, Laboratory of Neurovascular Pathology, Boulevard Sosnovyi, 6; Kemerovo 650002, Russian Federation. Tel./Fax: +7 3842643153; E-mail: [email protected].
Abstract: Background:Mild cognitive impairment (MCI) may contribute to the development of postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG). Objective:The aim of this study was to investigate the incidence of early and long-term POCD after CABG in coronary heart disease patients with and without preoperative MCI. Methods:The study enrolled two groups of males with coronary heart disease: 51 without MCI (mean age 56.0 ± 6.42 years) and 50 with MCI (mean age 56.4 ± 5.55 years). Baseline clinical characteristics as well as durations of cardiopulmonary bypass and aortic cross-clamping were similar between the two groups. MCI was defined as a Mini–Mental State Examination score of less than 28. All patients underwent detailed neuropsychological examinations (12 tests) before and 7–10 days and 1 year after surgery. The incidence of early and long-term POCD was estimated on the basis of criteria defined as a 20% decline on 20% of the tests. Results:Early POCD was diagnosed in 72% of cases in patients with MCI and in 79% of those without MCI (p = 0.5; odds ratio [OR] = 0.68; 95% confidence interval [CI] 0.2–2.2). Long-term POCD was diagnosed in 72% of MCI patients and in 70% of non-MCI patients (p = 0.8); OR = 1.08 (95% CI 0.4–2.9). Conclusions:Our results show that the presence of MCI is not the leading cause of either early or long-term POCD in patients undergoing CABG. Further research should focus on the contribution of important clinical factors, including progression of atherosclerosis and adherence, to post-CABG POCD.
