Changes of cognitive functions in patients with coronary heart disease after percutaneous coronary in-tervention:a correlation study
Pan Yu
Pang Li
Zhang Xiaoling
Li Quan
Ye Yicong
Yu Xianpeng
Zhao Xiliang
Wang Xiaoyi
Zeng Yong
Wang Xianpeng
Abstract：Objective To observe the influence of percutaneous coronary intervention(PCI)and coronary angiography(CAG)on perioperativecognitive function in patients with coronary heart disease(CHD),and discuss the correlation between clinical test indexes and cognitive impairment.Methods CHD patients(n=203)were continuously chosen from Department of Cardiology in Beijing Anzhen Hospital,and divided into CAG group(received CAG examination,n=55)and PCI group(received PCI,n=148).Before and 6 h after the operation,the processing speed,working memory and episodic memorywere detected by applying software system of basic cognitive ability test(BCAT),and at the same time,relevant laboratory examinations and operation-related clinical indexes were extracted in 2 groups.The differences in cognitive function scoreswere compared by using Wilcoxon signed-rank test between 2 groups before and after operation.The correlation among laboratory examination indexes,clinical indexes,and scores of postoperative processing speed,working memory and episodic memory were reviewed by using Pearson correlation coefficient.The influence of all examination indexes on scores of postoperative processing speed,working memory and episodic memory was reviewed by using multiple linear regression analysis.Results The scores of cognitive functions had no significant differences in CAG group before and after operation,and scores of processing speed and episodic memory were higher(P<0.05),and there was no significant difference in working memory(P>0.05)in PCI group than before.The results of correlation analysis showed that age was negatively correlated to scores of postoperative working memory(r=-0.258,P<0.01),and operation time negatively correlated toscoresof postoperative episodic memory(r=-0.206,P<0.05),high sensitivity C-reactive protein(hs-CRP)was negatively correlated to scores of postoperative processing speed(r=-0.273,P<0.01),and homocysteine(Hcy)was negatively correlated toscoresof preoperative and postoperative processing speeds(r=-0.288,P<0.01),and free triiodothyronine(fT3)was positively correlation to postoperative episodic memory(r=0.296,P<0.01)in PCI group.The results of multiple linear regression analysis showed that age was an independent risk factor for postoperative working memory(β=-0.238,P<0.05),hs-CRP and Hcy were independent factors for postoperative processing speed(β=-0.218--0.207,P<0.05),and fT3 was an independent protective factor for postoperative episodic memory(β=0.224,P<0.05)in PCI group.Conclusion The perioperative cognitiveimpairment will be aggravated in CHD patients received PCI,so the status of cognitive function should be screened and intervened before operation.Age,operation time,increased hs-CRP and Hcy levels,and decreased fT3 level are important influence factors for cognitiveimpairment after PCI.The levels of serum hs-CRP,Hcy and fT3 may have early predictive effects on cognitive impairment after PCI.
Keywords：Coronary interventionCognitive impairmentHigh sensitivity C-reactive proteinHomocysteine
Publication Date：2024-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 625-630 )