A Review of Acute Coronary Syndrome and its Potential Impact on Cognitive Function

Kasprzak, Dominika; Rzeźniczak, Janusz; Ganowicz, Teresa; Łuczak, Tomasz; Słomczyński, Marek; Hiczkiewicz, Jarosław; Burchardt, Paweł

doi:10.5334/gh.934

Cited by 11 publications

(9 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As indicated in Table 1, patients with CI found during hospitalization for MI had significantly lower GFRs (85 (73-101) vs. 90 (76-105); p = 0.02), as well as higher BNP levels (127.4 (73.1-265.1) vs. 96.9 (53.2-199.8); p = 0.01) and lower ejection fraction (48 (41-50) vs. 48 (45-54); p = 0.05), compared to those without deficits. It was also observed that those with CI were significantly older (60.4 (±10.2) vs. 58.3 (±9.3); p = 0.03) and scored higher on the SYNTAX scale (10 (7-16) vs. 9 (6)(7)(8)(9)(10)(11)(12)(13)(14); p = 0.05).…”

Section: Cognitive Impairmentmentioning

confidence: 85%

“…To date, a limited number of studies attempting an assessment of cognitive function in patients after MI have been published. Moreover, their assessment is also not part of routine daily clinical practice among cardiologists [7]. This may be due to the low awareness of the widespread presence of MCI and dementia in their patient population and a focus mainly on cardiovascular problems, neglecting a holistic approach to the patient.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study

Kasprzak,

Kaczmarek-Majer,

Rzeźniczak

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

(1) Background: Assessment of cognitive function is not routine in cardiac patients, and knowledge on the subject remains limited. The aim of this study was to assess post-myocardial infarction (MI) cognitive functioning in order to determine the frequency of cognitive impairment (CI) and to identify factors that may influence it. (2) Methods: A prospective study included 468 patients hospitalized for MI. Participants were assessed twice: during the first hospitalization and 6 months later. The Mini-Mental State Examination was used to assess the occurrence of CI. (3) Results: Cognitive dysfunction based on the MMSE was found in 37% (N-174) of patients during the first hospitalization. After 6 months, the prevalence of deficits decreased significantly to 25% (N-91) (p < 0.001). Patients with CI significantly differed from those without peri-infarction deficits in the GFR, BNP, ejection fraction and SYNTAX score, while after 6 months, significant differences were observed in LDL and HCT levels. There was a high prevalence of non-cognitive mental disorders among post-MI patients. (4) Conclusions: There is a high prevalence of CI and other non-cognitive mental disorders, such as depression, sleep disorders and a tendency to aggression, among post-MI patients. The analysis of the collected material indicates a significant impact of worse cardiac function expressed as EF and BNP, greater severity of coronary atherosclerosis expressed by SYNTAX results, and red blood cell parameters and LDL levels on the occurrence of CI in the post-MI patient population.

show abstract

Section: Cognitive Impairmentmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study

Kasprzak,

Kaczmarek-Majer,

Rzeźniczak

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…Tests for these domains should be included in any reduced assessment, as these domains are typically linked to vascular cognitive impairment and can impede patient insight and motivation and limit the capacity for self-care behaviors. 9 Adding to these difficulties, <30% completed ≥1 session of CR, the most effective intervention to support secondary prevention in ACS. 10 Direct, systematic referral to CR for patients screening positive for MCI as inpatients is recommended to promote prevention 11 and the study results strengthen the recommendation for CR in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, however, this study showed that multiple cognitive domains may be impaired post-ACS, including executive functioning and processing speed. Tests for these domains should be included in any reduced assessment, as these domains are typically linked to vascular cognitive impairment and can impede patient insight and motivation and limit the capacity for self-care behaviors 9. Adding to these difficulties, <30% completed ≥1 session of CR, the most effective intervention to support secondary prevention in ACS 10.…”

Section: Discussionmentioning

confidence: 99%

Predictive Accuracy of Inpatient Cognitive Screening for Correctly Classifying Mild Cognitive Impairment at 4 Months Using A Full Neurocognitive Battery in Acute Coronary Syndrome

Gallagher

Bassett

Zhao

et al. 2022

Journal of Cardiopulmonary Rehabilitation and Prevention

View full text Add to dashboard Cite

D ementia is a leading contributor to the global burden of disease due to progressive and unrelenting deterioration of the capacity of an individual to live independently. Vascular etiology is the second most common cause of dementia 1 and cardiovascular disease (CVD) results in faster decline. 2 Mild cognitive impairment (MCI), which may indicate early dementia, occurs frequently in acute coronary syndrome (ACS) patients. 3 Prevalence rates vary widely (9-85%), depending on timing and assessment method used. A recent report indicated 63% had MCI on screening 4 4-wk post-ACS. Data based on full neurocognitive assessment when recovery has progressed (4-mo post-ACS) are required for confirmation and to inform inpatient screening that reliably predicts MCI. Early detection of MCI enables timely intervention to potentially slow the progression of MCI to dementia and enable customizing of education and support. METHODSWe recruited consecutive ACS inpatients from two university hospitals in metropolitan Sydney, Australia. Included patients were free from dementia and proficient in English. Inpatient screening for MCI was undertaken using the Montreal Cognitive Assessment (MoCA) 5 and the Hopkins Verbal Learning Test (HVLT). 6 Together, these tests are sensitive to the cognitive decline common in vascular cognitive impairment. Mild cognitive impairment was classified as MoCA score <26 and/or HVLT ≥ −1 z-score. Participants were then assessed 4-mo post-ACS using a full neurocognitive battery conducted by qualified neuropsychologists in an accredited testing center (see Supplemental Digital Content Table 1, available at: http://links.lww.com/JCRP/A432). Testing determined if patients met clinical criteria for MCI, as well as classification of amnestic and nonamnestic MCI

show abstract

“…Coronary artery disease (CAD) is the main cause of mortality and morbidity worldwide, causing over 8 million deaths worldwide each year and a huge burden on social care systems [ 1 ]. Asians exhibited greater susceptibility to CAD and diabetes mellitus (DM) compared to Westerners, due to higher levels of central obesity and total adiposity or higher degree of insulin resistance and endothelial dysfunction [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Machine learning-based models to predict one-year mortality among Chinese older patients with coronary artery disease combined with impaired glucose tolerance or diabetes mellitus

Li¹,

Guan

Ning

et al. 2023

Cardiovasc Diabetol

View full text Add to dashboard Cite

Purpose An accurate prediction of survival prognosis is beneficial to guide clinical decision-making. This prospective study aimed to develop a model to predict one-year mortality among older patients with coronary artery disease (CAD) combined with impaired glucose tolerance (IGT) or diabetes mellitus (DM) using machine learning techniques. Methods A total of 451 patients with CAD combined with IGT and DM were finally enrolled, and those patients randomly split 70:30 into training cohort (n = 308) and validation cohort (n = 143). Results The one-year mortality was 26.83%. The least absolute shrinkage and selection operator (LASSO) method and ten-fold cross-validation identified that seven characteristics were significantly associated with one-year mortality with creatine, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and chronic heart failure being risk factors and hemoglobin, high density lipoprotein cholesterol, albumin, and statins being protective factors. The gradient boosting machine model outperformed other models in terms of Brier score (0.114) and area under the curve (0.836). The gradient boosting machine model also showed favorable calibration and clinical usefulness based on calibration curve and clinical decision curve. The Shapley Additive exPlanations (SHAP) found that the top three features associated with one-year mortality were NT-proBNP, albumin, and statins. The web-based application could be available at https://starxueshu-online-application1-year-mortality-main-49cye8.streamlitapp.com/. Conclusions This study proposes an accurate model to stratify patients with a high risk of one-year mortality. The gradient boosting machine model demonstrates promising prediction performance. Some interventions to affect NT-proBNP and albumin levels, and statins, are beneficial to improve survival outcome among patients with CAD combined with IGT or DM.

show abstract

A Review of Acute Coronary Syndrome and its Potential Impact on Cognitive Function

Cited by 11 publications

References 40 publications

Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study

Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study

Predictive Accuracy of Inpatient Cognitive Screening for Correctly Classifying Mild Cognitive Impairment at 4 Months Using A Full Neurocognitive Battery in Acute Coronary Syndrome

Machine learning-based models to predict one-year mortality among Chinese older patients with coronary artery disease combined with impaired glucose tolerance or diabetes mellitus

Contact Info

Product

Resources

About