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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Cognitive decline and ischemic microlesions after coronary catheterization. A comparison to coronary artery bypass

Niko Schwarz1, Markus Schoenburg, Helge Möllmann

  • 1Department of Neurology, Justus Liebig University Giessen, Germany.

American Heart Journal
|October 11, 2011
PubMed

Insights

Postinterventional cognitive dysfunction (PICD) occurs less frequently after coronary catheterization than after coronary artery bypass grafting (CABG). While milder, PICD after catheterization is not negligible.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Postinterventional cognitive dysfunction (PICD) is a recognized complication following coronary artery bypass grafting (CABG).
  • The occurrence of PICD after coronary catheterization remains largely uninvestigated.
  • This study aims to compare cognitive outcomes and cerebral lesions after these two cardiac procedures.

Purpose of the Study:

  • To investigate the incidence and severity of PICD after coronary catheterization.
  • To compare PICD and cerebral lesions between patients undergoing coronary catheterization and CABG.
  • To assess the association of PICD with depression, anxiety, and quality of life.

Main Methods:

  • Neuropsychological assessments were conducted on 37 coronary catheterization patients, 47 CABG patients, and 33 healthy controls at baseline and 3 months post-intervention.
  • Analysis of covariance was used to compare outcomes, adjusting for baseline scores.
  • Cerebral magnetic resonance imaging with diffusion-weighted imaging (DWI) was performed on a subset of patients to detect acute ischemic lesions.

Main Results:

  • The rate of acute ischemic lesions was 3.3% in the catheter group versus 17.9% in the CABG group.
  • PICD was detected in 2 out of 10 tests in the catheter group compared to healthy controls.
  • The CABG group exhibited PICD in 7 out of 10 tests compared to healthy controls.

Conclusions:

  • Coronary artery bypass grafting (CABG) is associated with a higher incidence and severity of postinterventional cognitive dysfunction (PICD) and cerebral lesions compared to coronary catheterization.
  • While PICD after coronary catheterization appears substantially milder than after CABG, it is not negligible.
  • Depression, anxiety, and health-related quality of life were not significantly associated with PICD in either group.
Abstract

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