Cognitive function in patients with coronary artery disease: A literature review

Burkauskas, Julius; Lang, Peter; Bunevičius, Adomas; Neverauskas, Julius; Bučiūtė-Jankauskienė, M.; Mickuvienė, Narseta

doi:10.1177/0300060517751452

Cited by 24 publications

(14 citation statements)

References 78 publications

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Section: Coronary Artery Diseasementioning

confidence: 99%

“…In the general population, CAD or myocardial infarction is associated with poorer general cognition and loss of verbal fluency, but the pathogenetic mechanism of that association remains elusive (Burkauskas et al 2018;Sundbøll 2018). CAD per se may lead to AF and heightened platelet activation, which, in turn, might trigger perivascular inflammation in the brain (Burkauskas et al 2018;Frazier et al 2014). Overall, it is estimated that cART-treated PLHIVs are at 1.5-fold higher risk of clinical and subclinical CAD, with men having a lower relative risk (1.12) than women (1.99), compared to HIV-negative individuals (Boccara et al 2013;Baldé et al 2019).…”

Section: Coronary Artery Diseasementioning

confidence: 99%

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Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders

Moulignier¹,

Costagliola²

2020

Current Topics in Behavioral Neurosciences

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Evidence from epidemiological studies on the general population suggests that midlife cardiovascular disease (CVD) and/or metabolic syndrome (MetS) are associated with an increased risk of cognitive impairment and dementia later in life. In the modern combined antiretroviral therapy (cART) era, as in the general population, CVD and MetS were strongly and independently associated with poorer cognitive performances of sustained immunovirologically controlled persons living with human immunodeficiency viruses (PLHIVs). Those findings suggest that CV/metabolic comorbidities could be implicated in the pathogenesis of HIV-associated neurocognitive disorders (HAND) and might be more important

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Section: Coronary Artery Diseasementioning

confidence: 99%

Section: Coronary Artery Diseasementioning

confidence: 99%

Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders

Moulignier¹,

Costagliola²

2020

Current Topics in Behavioral Neurosciences

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“…Interestingly, the mediating effect of plasma BDNF on platelet activity related cognitive decline was significantly lower in CAD patients than in subjects without CAD. Knowing that patients with CAD are at higher risk of cognitive impairment ( 39 ), the mechanisms behind this weakened protective effect of BDNF on platelet-related cognitive deterioration is worthy of further investigation. Future studies should examine in vitro the content and release of BDNF from platelets isolated from CAD and non-CAD individuals, to have a better understanding of mechanisms regulating platelet BDNF secretion in health and disease.…”

Section: Discussionmentioning

confidence: 99%

Brain-Derived Neurotrophic Factor Mitigates the Association Between Platelet Dysfunction and Cognitive Impairment

Bélanger

Bouchard

Blanc

et al. 2021

Front. Cardiovasc. Med.

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Background: Platelet hyperactivity is deleterious in coronary artery disease (CAD), requiring lifelong antiplatelet therapy, and is associated with worse cognitive outcomes. Upon activation, platelets release Brain-Derived Neurotrophic Factor (BDNF), a neurotrophin protective against cognitive decline. Given these apparently opposing effects of platelet activation on cognitive health, we investigated whether BDNF levels intercede in the relationship between platelet activation and cognitive function; and whether this relationship is moderated by the presence of CAD.Methods: In this cross-sectional study, 1,280 participants with (n = 673) and without CAD (n = 607) completed the Montreal Cognitive Assessment (MoCA). Plasma BDNF and soluble P-selectin (a marker of platelet activity) levels were assessed using multiplex flow cytometry.Results: In a mediation model, platelet activity was correlated with higher plasma BDNF concentrations (b = 0.53, p < 0.0001). The relationship between sP-selectin and BDNF concentrations was stronger for individuals without CAD (b = 0.71, p < 0.0001) than for CAD participants (b = 0.43, p < 0.0001; pinteraction <0.0001). Higher BDNF concentrations were associated with higher MoCA scores (b = 0.26, p = 0.03). The overall effect of platelet activity on cognitive performance was non-significant (total effect: b = −0.12, p = 0.13), and became significant when accounting for BDNF as a mediating factor (direct effect: b = −0.26, p = 0.01). This resulted in a positive indirect effect of platelet activity (via BDNF) on MoCA scores (b = 0.14, CI 95% 0.02–0.30), that was smaller in CAD participants than in non-CAD participants [Δ −0.07 (95% CI −0.14 to −0.01)].Conclusions: BDNF released from activated platelets could be a mitigating factor in a negative association between platelet activity and cognitive function.

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“…Post-hoc meta-regression analyses showed that the association between CAD and cognitive decline was unchanged after adjusting for risk factors such as diabetes, hypertension, and dyslipidemia, suggesting that this association cannot be solely explained by cardiovascular risk factors [17]. A systematic review identified CABG, apolipoprotein E4, left ventricular ejection fraction, medication use, and hormones and biomarkers as predictors of cognitive decline in patients with CAD [30].Conversely, a prospective longitudinal study found no significant differences in long-term cognitive outcomes among CAD patients treated surgically with on-pump CABG (n = 152) or off-pump CABG (n = 75)) or non-surgically (n = 99) [6]. This is consistent with our results from univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Impact of Coronary Artery Disease on Long-Term Cognitive Outcome after Ca- rotid Endarterectomy

Nakamizo¹

2019

Journal of Cardiology and Vascular Medicine

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Objective: Carotid stenosis and coronary artery disease (CAD) are associated with cognitive decline, but little is known about the impact of CAD on cognitive outcome after carotid endarterectomy (CEA). The aim of this study was to assess the long-term cognitive outcomes after CEA in patients with CAD and to identify causative risk factors for cognitive decline.Methods: Among 36 consecutive patients with CAD who had undergone CEA between February 2016 and June 2018, and 45 patients without CAD who had undergone CEA during the same period, cognitive functions were studied using the Neurobehavioral Cognitive Status Examination (Cognistat) and the Frontal Assessment Battery (FAB). Cognitive decline was defined as both FAB total score below the cutoff value and severe impairment in at least one domain on Cognistat.Results: Cognitive decline was evident in 27.8% of patients with CAD at a mean of 7.2 years after CEA, and in 8.9% of patients without CAD. Comprehension, memory, and conceptualization were significantly impaired in patients with CAD compared to patients without CAD (p=0.0274, 0.0392, and 0.0113, respectively).In patients with CAD, univariate analysis revealed that deep white matter hyperintensity (DWMH) and chronic kidney disease associated with cognitive decline (odds ratio (OR) 32.2, 95% confidence interval (CI) 3. p=0.0032; OR 6.11, p=0.0360, respectively).Conclusions: This result may be useful to better identify individuals at high risk of cognitive decline long after CEA.

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Cognitive function in patients with coronary artery disease: A literature review

Cited by 24 publications

References 78 publications

Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders

Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders

Brain-Derived Neurotrophic Factor Mitigates the Association Between Platelet Dysfunction and Cognitive Impairment

Impact of Coronary Artery Disease on Long-Term Cognitive Outcome after Ca- rotid Endarterectomy

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