• J. Alzheimers Dis. · Jan 2014

    Does preoperative mild cognitive impairment predict postoperative cognitive dysfunction after on-pump coronary bypass surgery?

    • Olga A Trubnikova, Anastasia S Mamontova, Irina D Syrova, Olga V Maleva, and Olga L Barbarash.
    • Department of Polyvascular Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Sciences, Kemerovo, Russian Federation.
    • J. Alzheimers Dis. 2014 Jan 1;42 Suppl 3:S45-51.

    BackgroundMild cognitive impairment (MCI) may contribute to the development of postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG).ObjectiveThe 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.MethodsThe 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.ResultsEarly 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).ConclusionsOur 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.

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