Alʹmanah Kliničeskoj Mediciny (Feb 2016)

NEUROCOGNITIVE SCREENING IN ISCHEMIC HEART DISEASE PATIENTS WHO NEED SURGICAL TREATMENT

  • M. A. Litvinenko,
  • A. S. Kotov,
  • S. V. Romanov,
  • S. A. Terpigorev,
  • T. G. Kabanova,
  • M. N. Borisova

DOI
https://doi.org/10.18786/2072-0505-2015-39-51-55
Journal volume & issue
Vol. 0, no. 39
pp. 51 – 55

Abstract

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Background: Coronary artery atherosclerosis is one of the main causes of ischemic heart disease. Formation of chronic vascular brain insufficiency in ischemic heart disease has a complex pathogenesis and can be related to a lower cardiac output. Occurrence and progression of neurodegenerative process in such patients can manifest by significant cognitive impairment deteriorating their quality of life and leading to social disadaptation.Aim: To assess neuropsychological functions in patients with coronary artery atherosclerosis and to identify potential risk factors predisposing to the development of cognitive and neurological impairment.Materials and methods: The study included 30 patients with stable angina requiring coronary surgical interventions and 25 patients with acute coronary syndrome. The patient age was 57.3 ± 1.8 and 58.3 ± 10.9 years, respectively. In 15 of cases, acute coronary syndrome was associated with ST elevation on ECG and in 10 of cases no ST elevation was noted. All patients were seen by a neurologist and underwent neuropsychological testing. The patients were divided into two groups: those in need of a stent placement (group 1), those in need of coronary artery bypass grafting (group 2) and those with acute coronary syndrome ( group 3).Results: Assessment of cognitive functions with a Montreal cognitive assessment scale gave the following results: the total mean score in the group 1 was 24.3 ± 0.5, in the group 2, 26.3 ± 0.5 (normal at least 26), the difference between the groups being statistically significant (p = 0.0172). Cognitive impairment was more frequently found in acute coronary syndrome patients with ST elevation, who had more severe cardiac abnormalities, compared to those with acute coronary syndrome without ST elevation.Conclusion: Most patients with clinically significant atherosclerosis of coronary arteries have mild and moderate cognitive disorders, that indicate the importance of a neuropsychological screening for early detection of cognitive and neurological impairment in such patients.

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