Contemporary Incidence of Cognitive Impairment or Dementia in Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis

Author:

Lo Hui Zhen,Wee Caitlin Fern,Low Chen Ee,Teo Yao Hao,Teo Yao Neng,Yun Choi Ying,Syn Nicholas L.ORCID,Tan Benjamin Y.Q.,Chai Ping,Yeo Leonard L.L.,Yeo Tiong-Cheng,Chong Yao Feng,Poh Kian-Keong,Kong William K.F.,Wong Raymond C.C.,Chan Mark Y.,Sia Ching-Hui

Abstract

<b><i>Introduction:</i></b> Despite the high prevalence of cognitive impairment or dementia post-coronary artery bypass grafting (CABG), the incidence of cognitive impairment or dementia post-CABG in contemporary practice is currently unclear. Therefore, this paper aims to investigate the incidence and associated risk factors of cognitive impairment or dementia in patients’ post-CABG. <b><i>Methods:</i></b> A systematic search across three databases (PubMed, SCOPUS, and Embase) was conducted for studies published in or after 2013 that reported cognitive impairment or dementia post-CABG. Subgroup analyses and meta-regression by risk factors were performed to determine their influence on the results. <b><i>Results:</i></b> This analysis included 23 studies with a total of 2,620 patients. The incidence of cognitive impairment or dementia less than 1 month, 2 to 6 months, and more than 12 months post-CABG was 35.96% (95% confidence interval [CI]: 28.22–44.51, <i>I</i><sup>2</sup> = 87%), 21.33% (95% CI: 13.44–32.15, <i>I</i><sup>2</sup> = 88%), and 39.13% (95% CI: 21.72–58.84, <i>I</i><sup>2</sup> = 84%), respectively. Meta-regression revealed that studies with more than 80% of the cohort diagnosed with hypertension were significantly associated with incidence of cognitive impairment or dementia less than 1 month post-CABG. <b><i>Conclusion:</i></b> This meta-analysis demonstrates a high incidence of cognitive impairment or dementia in patients’ post-CABG in contemporary practice, particularly less than 1 month post-CABG and more than 12 months post-CABG. We found that hypertension was a significant risk factor in the short-term (less than 1 month) follow-up period for cognitive impairment or dementia post-CABG. Future research should be done to assess strategies to reduce cognitive impairment post-CABG.

Publisher

S. Karger AG

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