Assessment of cognitive decline after cardiac intervention (surgical and percutaneous) and identification of factors that may influence it

Abstract

Cardiac surgery and percutaneous vascular interventions have improved patient management and survival in recent years, but questions remain about the neurological and particularly cognitive complications associated with them. The objective of the COGCAR study is to assess the occurrence of cognitive decline after cardiac intervention (surgical or percutaneous) using Mattis Dementia Rating Scale (DRS), and to identify factors that may influence it. We followed 122 patients prospectively for 1 year, from 2008 to 2016, after cardiac surgery. A cognitive assessment was performed at inclusion and 3 weeks after the intervention. Cognitive decline was defined as a loss of at least 2 points on Mattis overall cognitive score between the two assessments. Among the 122 patients included, 39 patients (32%) showed cognitive decline. The potential predictive factors for post-interventional cognitive decline found in our study were the age, the MMSE, the intelligence level and a TAVR type intervention. Our multivariate analysis shows that age appears to be the only predictor of cognitive decline after cardiac intervention. These data are rather reassuring at a time when TAVR indications could be extended to younger patients.