Cognitive impairment (CI) is a well-known predictor of mortality and readmissions in patients with coronary arteries disease (CAD) and heart failure (HF). But today, prevalence of CI is often underestimated. Therefore, evaluation of real prevalence of CI and it’s possible markers in CAD patients are very important.
Purpose of the study was to evaluate the prevalence of CI in patients with CAD and it’s relationship with diastolic dysfunction and left ventricle filling pressure (LVFP).
For 110 patients with established CAD (prior myocardial infarction (MI), unstable angina (UA), percutaneous coronary intervention or coronary arteries bypass grafting) by Euroaspire V in Ukrainian cohort testing of cognitive functioning by validated scales – MMSE, MoCA – and echocardiography were performed. By results of echocardiography all patients were divided in four groups: I – E/e’ ratio<10, E/A>0,8; II – E/e’ ratio<10, E/A<0,8; III – E/e’ ratio – 10-14; IV – E/e’ ratio >14.
The average age of patients was 60.1 ± 8.74 years. 71.8% male patients, 28.2% of women. In 64,5% of cases, there was prior MI, and in 35,5% - unstable angina. There are no differences in age, diabetes mellitus prevalence, office blood pressure levels, left ventricle ejection fraction between groups were noted. Testing by MMSE scale showed, that 20,9% of patients had no CI, in 50% of patients mild CI was observed. Mild dementia was noted in 23,6% and dementia of moderate degree – in 5,45% of patients. Mean score by MMSE scale in I group was 25,7±2,57; II – 25,0±2,50, III– 23,4±3,04; IV – 21,1±2,69. Comparison of groups showed that mean score by MMSE was significantly lower in III and IV groups (p1,3=0.0018, p1,4<0.0001). Negative correlation between E/e’ ratio and MMSE score was noted (r=-0.47). Mean score on the MoCA scale was in the first group 23.6 ± 3.30, in the second group - 22.5 ± 3.70, in the third - 21.4 ± 5.17, in the fourth - 17.9 ± 4.17 . In comparison with the first group, the significantly worse values are also noted in III I IV groups (p1,3 = 0,04, p1,4 = <0.0001).
In patients with diastolic function and high LVEF, no normal cognitive function by MMSE and MoCA scales was observed. In patients with diastolic dysfunction and elevated LVEF there are significantly lower rates of cognitive function than in patients with normal diastolic function. A negative correlation (r = -0.47) between E/e’ ratio and MMSE score was noted.