Increased Carotid Intima-Media Thickness was not Associated With Cognitive Dysfunction After Off-Pump Coronary Surgery in Older Adult Patients Without Carotid Stenosis

Increased carotid intima-media thickness (C-IMT), a marker of atherosclerosis, is known to be associated with cerebrovascular and cortical abnormalities and cognitive impairment. This prospective observational study investigated the association between increased C-IMT and postoperative cognitive dys...

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Published in:Seminars in thoracic and cardiovascular surgery 2022-01, Vol.34 (1), p.112-121
Main Authors: Lee, Bora, Kim, Kwang-Sup, Shim, Jae-Kwang, Kim, Hye-Bin, Jun, Byongnam, Kwak, Young-Lan
Format: Article
Language:English
Subjects:
Aged
Carotid Intima-Media Thickness
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - surgery
Cognitive Dysfunction - epidemiology
Coronary artery bypass, Off-pump
Coronary Artery Bypass, Off-Pump - adverse effects
Female
Humans
Male
Postoperative cognitive complications
Risk Factors
Treatment Outcome
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Summary:Increased carotid intima-media thickness (C-IMT), a marker of atherosclerosis, is known to be associated with cerebrovascular and cortical abnormalities and cognitive impairment. This prospective observational study investigated the association between increased C-IMT and postoperative cognitive dysfunction (POCD) in older adult patients undergoing off-pump coronary artery bypass surgery. A total of 201 patients (57 females, 144 males; >60 years) were classified into increased (n = 105) or normal (n = 96) C-IMT groups by a cut-off value of 0.9 mm (bilateral C-IMT mean). Cognitive function was serially assessed with the Korean Mini-Mental State Examination, and Korean Montreal Cognitive Assessment scores preoperatively and at 7 days and 3 months postoperatively. POCD was defined as the deterioration of 1 standard deviation in at least one of the postoperative tests compared with their corresponding baseline scores. Independent risk factors for POCD were evaluated using multivariable analysis. Overall, POCD occurred in 46 patients (23%) over the 3 months. The incidences of POCD at 7 days and 3 months after surgery were similar, and there was no difference in both Korean Mini-Mental State Examination and Korean Montreal Cognitive Assessment test scores before and after surgery between groups. Chronic obstructive lung disease and intraoperative hyperglycemia episodes (>180 mg/dL), but not increased C-IMT, were independent risk factors for POCD. Unlike in nonsurgical cohorts, increased C-IMT was not significantly associated with the occurrence of POCD in older adult patients undergoing off-pump coronary artery bypass surgery. [Display omitted]
ISSN:1043-0679
1532-9488
DOI:10.1053/j.semtcvs.2021.03.004