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Does Coronary Angiography and Percutaneous Coronary Intervention Affect Cognitive Function?

Juliane Jurga1, Per Tornvall2, Linda Dey1

  • 1Unit of Cardiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.

The American Journal of Cardiology
|September 17, 2016
PubMed

Insights

This study found no significant cognitive decline after coronary angiography or intervention, despite cerebral microemboli. Mild cognitive impairment was common before procedures, regardless of access site.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Cerebral microemboli are common during coronary angiography (CA) and percutaneous coronary intervention (PCI).
  • The clinical impact of these microemboli and their association with vascular access site is debated.
  • Pre-existing mild cognitive impairment is prevalent in patients with suspected coronary heart disease.

Purpose of the Study:

  • To assess postprocedural cognitive impairment after CA or PCI using the Montreal Cognitive Assessment (MoCA) test.
  • To investigate the correlation between cerebral microemboli and cognitive function.
  • To compare cognitive outcomes based on vascular access site (radial vs. femoral).

Main Methods:

  • 93 patients undergoing CA or PCI were randomized to radial or femoral access.
  • Serial cognitive testing was performed using the MoCA test pre- and post-procedure.
  • Cerebral microemboli were monitored using transcranial Doppler in a subgroup of 35 patients.

Main Results:

  • The median MoCA test score was 27 pre-procedure and did not change significantly post-procedure (4 and 31 days).
  • No significant correlation was found between the number of cerebral microemboli and MoCA test score changes.
  • Cognitive test results did not differ significantly between radial and femoral access groups.

Conclusions:

  • The MoCA test did not detect significant cognitive impairment following CA or PCI.
  • Cerebral microemboli and vascular access site were not significantly correlated with postprocedural cognitive changes.
  • Mild cognitive impairment is a common finding in patients referred for coronary procedures.

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