Predictors of Persistant Post-Operation Cognitive Dysfunction in 2 Type Diabetes Patients After Coronary Bypass Grafting

Трубникова, О. А.; Мамонтова, А. С.; Малева, О. В.; Тарасова, И. В.; Кухарева, И. Н.; Кузьмина, А. А.; Kagan, Elena; Барбараш, О. Л.

doi:10.15829/1560-4071-2016-2-12-18

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…Importantly, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and calcium antagonists did not show any significant correlations with the outcomes followed CABG [78]. However, there are available data on beneficial effects of statins on reducing the incidence of atrial fibrillation and cognitive impairment after CABG, including patients with diabetes mellitus [48,78].…”

Section: Comprehensive Risk Factor Control In Diabetic Patients In Comentioning

confidence: 99%

“…Diabetic patients showed higher endothelial activation and lower antiinflammatory response to CPB compared to non-diabetics [46]. Chronic hyperglycemia can lead to the central nervous system injury, resulting in diabetic encephalopathy with the onset of mild and moderate cognitive disorders [48]. Bruce et al found that 64% of diabetic patients with coronary artery disease had cognitive or emotional disorders [49].…”

Section: Diabetes-specific Risk Factors For Adverse Prognosis In Coromentioning

confidence: 99%

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Coronary Artery Bypass Grafting in Patients with Diabetes Mellitus: A Cardiologist’s View

Alexandrovna¹,

Nikolaevich²,

Viktorovich³

et al. 2017

Coronary Artery Bypass Graft Surgery

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The review presents current data on the prevalence of diabetes in the cohort of patients undergoing coronary artery bypass grafting. The relevance of active approach to the identification of diabetes and prediabetes in patients with coronary artery disease (CAD) before coronary revascularization is reviewed. Recent information about the negative impact of diabetes on the prognosis of myocardial revascularization is reported as well as the main mechanisms responsible to the development of adverse outcomes of interventions in these patients. Target perioperative values of glycemia recommended by the leading associations of the study of diabetes have been compared. Beneficial potential of other carbohydrate metabolism markers (glycated hemoglobin, fructosamine, 1,5-anhydroglucitol) in patients with diabetes mellitus (DM) in terms of their impact on cardiovascular prognosis, including coronary intervention. The results of studies comparing different management strategies for these patients are reviewed. The significance of carbohydrate metabolism compensation during myocardial revascularization is reported; thus, a too stringent glycemic control has no benefits neither for percutaneous nor for open coronary intervention. Recent trials suggest the groups of antidiabetic drugs and evidence of their impact on the cardiovascular system. The importance of comprehensive monitoring of major risk factors in diabetic patients with coronary intervention has been proved.

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Section: Comprehensive Risk Factor Control In Diabetic Patients In Comentioning

confidence: 99%

Section: Diabetes-specific Risk Factors For Adverse Prognosis In Coromentioning

confidence: 99%

Coronary Artery Bypass Grafting in Patients with Diabetes Mellitus: A Cardiologist’s View

Alexandrovna¹,

Nikolaevich²,

Viktorovich³

et al. 2017

Coronary Artery Bypass Graft Surgery

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“…У больных СД отмечается и более высокая эндотелиальная активация и низкая антивоспалительная реакция при операции КШ с искусственным кровообращением по сравнению с больными без СД [42]. Хроническая гипергликемия приводит к повреждению ЦНС и формированию диабетической энцефалопатии с формированием легких и умеренных когнитивных расстройств [44]. Bruce D. G. обнаружил, что 64% пациентов с СД и ИБС имеют когнитивные или эмоциональные расстройства [45].…”

Section: характерные для диабета факторы риска неблагоприятного прогнunclassified

“…У больных КШ высокая вариабельность гликемии ассоциирована с риском послеоперационных осложнений. Высвобождение катехоламинов в ответ на гипогликемию сопровождается также снижением уровня калия плазмы, что приводит к удлинению интервала QT на ЭКГ, нарушению процессов реполяризации миокарда и может спровоцировать возникновение аритмий, в том числе ФП [44].…”

Section: характерные для диабета факторы риска неблагоприятного прогнunclassified

Patients With Diabetes and Myocardial Revascularization From Evidence-Based Medicine Positions: Cardiologist’s Opinion. Part 1

Безденежных¹,

Сумин²,

Барбараш³

2017

Russ J Cardiol

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В обзоре приведены современные данные по распространенности сахарного диабета (СД) в когортах пациентов, подвергающихся коронарному шунтированию и чрескожному коронарному вмешательству. Показана целесообразность активного подхода к выявлению диабета и предиабета у пациентов с ишемической болезнью сердца перед коронарной реваскуляризацией. Представлена актуальная информация о негативном влиянии СД на прогноз реваскуляризации миокарда, и освещены основные механизмы, ответственные за развитие неблагоприятных исходов вмешательства у данной категории больных. Сопоставлены целевые периоперационные значения гликемии, рекомендованные ведущими сообществами по изучению диабета, и показана роль других маркеров углеводного обмена (гликированный гемоглобин, фруктозамин, 1,5-ангидроглюцитол) у пациентов с СД в аспекте их вклада в сердечно-сосудистый прогноз, в том числе при коронарных вмешательствах.

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Comparative analysis of two multitask approaches to cognitive training in cardiac surgery patients

Tarasova,

Kukhareva,

Temnikova

et al. 2024

Russ J Cardiol

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Aim. To compare the incidence of postoperative cognitive dysfunction and neuropsychological changes in the early postoperative period of coronary artery bypass grafting (CABG) in patients who underwent two versions of multitask cognitive training, which involved various cognitive and motor tasks, as well as in a control group.Material and methods. The study included 100 patients after elective CABG. All patients were randomly divided into three following groups: cognitive training (CT) 1 (postural balance combined with mental arithmetic, verbal fluency, and unusual object use tasks) (n=30), CT 2 (simple visual-motor response combined with task on mental arithmetic, verbal fluency and unusual object use) (n=35) and without training (standard postoperative therapy) (n=35). All patients underwent extensive neuropsychological testing before CABG. Reexamination with assessment of postoperative cognitive dysfunction (POCD) was carried out on days 2-3 and upon completion of 5-7 days of training or on days 11-12 after CABG.Results. The presence of POCD on days 2-3 was found in 100% of patients in the study groups. On days 11-12 of CABG, POCD persisted in 17 people (56,7%) from the CT 1 group, in 24 (68,6%) from the CT 2 group, and in 28 (80%) patients in the control group. Significant differences were obtained in the POCD prevalence in the CT 1 and control groups (odds ratio =3,06; 95% confidence interval: 1,02-9,18, p=0,04), but not CT 2 and control groups (odds ratio =1,83; 95% confidence interval: 0,64-5,47, p=0,28).Conclusion. Multitask training using a combination of postural balance and mental arithmetic tasks, verbal fluency, and unusual object use had a greater effect in reducing the POCD incidence in patients after CABG compared with standard postoperative care. The results of this study may be used to develop cognitive rehabilitation programs in cardiology and cardiac surgery.

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Predictors of Persistant Post-Operation Cognitive Dysfunction in 2 Type Diabetes Patients After Coronary Bypass Grafting

Cited by 3 publications

References 4 publications

Coronary Artery Bypass Grafting in Patients with Diabetes Mellitus: A Cardiologist’s View

Coronary Artery Bypass Grafting in Patients with Diabetes Mellitus: A Cardiologist’s View

Patients With Diabetes and Myocardial Revascularization From Evidence-Based Medicine Positions: Cardiologist’s Opinion. Part 1

Comparative analysis of two multitask approaches to cognitive training in cardiac surgery patients

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