The state of cognitive function in patients with stable coronary artery disease after coronary artery bypass grafting

Abstract

Aim      To study the cognitive function (CF) state in patients with chronic ischemic heart disease (IHD) depending on the method of coronary bypass (CB), with extracorporeal circulation (EC) or on beating heart.Material and methods  Postoperative cognitive dysfunction (POCD) is a frequent complication of CB, and its development may depend on the method of surgery, with EC or on beating heart. This single-center, prospective, nonrandomized study included 196 patients with chronic IHD aged 61.0±5.1 years. Patients were divided into two groups based on the CB method: an EC group (n=11) and a beating heart surgery group (n=85). Mean follow-up period was 26±2.1 mos. The state of CF was evaluated before and after CB (at the hospital stage, at 3, 6, 12, and 24 mos.).Results The mean duration of CF recovery was 3 mos. only in the group of CB without EC (p<0.05), whereas after CB with EC, CF parameters were similar to those during the hospital stage with somewhat reduced values. In 6 mos. after CB, CF normalized to baseline values in both groups (with and without EC). A possible CF decline in patients with chronic IHD after CB depended on the following factors: age older than 60 years (p<0.05), diabetes mellitus with glycated hemoglobin >7.5 % (p=0.001) and 6.5–7.5 % (p=0.03), smoking (p=0.04), atherosclerotic damage of the internal carotid artery (p<0.05), and a Charlson comorbidity index >5 (p=0.03). The CB surgery either with EC (p=0.04) or on beating heart (p=0.04) was associated with the development of CD.Conclusion      The results of the study allow identifying patients with chronic IHD and POCD-predisposing factors to recommend them beathing heart CB surgery.