Evaluation of Cognitive Functions in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Prospective Pilot Study

TL;DR

This study found that young patients with heart attacks experience temporary cognitive issues, but no lasting brain changes.

Contribution

The study is the first to show transient cognitive impairment in young ACS patients without structural brain changes.

Findings

25 patients showed cognitive impairment on the first day, but only 18 had it after a month.

Cognitive test scores improved significantly in the Fazekas+ group after one month.

No structural brain differences were found between impaired and normal cognitive function groups.

Abstract

Purpose: It is not clear whether cognitive functions are impaired in young patients with acute coronary syndrome (ACS). This study aims to detect whether or not there is cognitive impairment and cerebral changes in young patients with ACS undergoing percutaneous coronary intervention (PCI). Patients and Methods: All 50 patients with ACS who were treated with primary PCI were eligible for this prospective study. All participants had normal cognitive function before ACS. Brain magnetic resonance imaging (MRI) was performed to quantify changes in brain white and gray matter. Cognitive functions (CFs) were evaluated by seven cognitive tests. Patients were categorized by MRI findings and test scores were compared from the first day to after the first month. Results: We determined 25 patients with impaired CFs on the first day. After the first month, we identified 18 patients with transient impaired CFs. No structural difference was observed between impaired CF and normal CF. While 25 patients had a score of 1 according to Fazekas, 10 patients had a score of 1 according to MTLA. While the mean Stroop test completion time and Stroop test error rate scores were significantly higher on the first day than after the first month in the Fazekas+ group (p = 0.003, p < 0.001, respectively), other cognitive test scores—except clock drawing test, digital span forwards, and backwards—were significantly lower on the first day compared to after the first month in the Fazekas+ group (p < 0.05). Conclusions: Patients with ACS have transient impairment in cognitive functions. Acute coronary syndrome is not associated with structural changes in the brain.

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