Abstract
IntroductionThis study aims to evaluate late postoperative neurophysiological outcomes in patients after coronary artery bypass grafting (CABG).MethodsForty-five male patients with stable coronary artery disease aged 45-69 years underwent extended neuropsychological assessment using the software Status PF and electroencephalographical examination 3-5 days before CABG and 5-7 years after CABG. Postoperative decline in cognitive functions was determined by a 20% decrease in the cognitive indicator compared to that at baseline on 20% of the tests included in the Status PF battery. Statistical analysis was performed using the software STATISTICA 10.0. Multiple regression was used to identify demographic, clinical, and electroencephalographical variables associated with adverse cognitive outcomes.ResultsCognitive decline was observed in 54% of the patients in the long-term postoperative period. Five to seven years after CABG, all patients have shown an increase in the theta rhythm power compared to the preoperative values, which is most pronounced in the frontal and temporal areas of the right hemisphere (P=0.04), along with a decrease in the alpha rhythm in the posterior areas of the cortex (P=0.005). Multiple regression has reported that the main predictors of cognitive impairment are slower mean alpha frequency, decreased theta-2 rhythm with eyes closed in the right temporal area, and increased theta-2 rhythm with eyes open in the left temporal area (F(5.39)=8.81; P<0.00007; adjusted R-squared=0.57).ConclusionOur findings indicate that 54% of the patients suffer from postoperative cognitive decline associated with increased theta and decreased alpha rhythms 5-7 years after CABG.
Highlights
This study aims to evaluate late postoperative neurophysiological outcomes in patients after coronary artery bypass grafting (CABG)
Recent studies have demonstrated that early Postoperative cognitive dysfunction (POCD) occurs in almost 70% of patients undergoing coronary artery bypass grafting (CABG)
The exclusion criteria were as follows: diagnosis of neurological or psychiatric disorders that may interfere with cognition; patients with severe depression[12]; severe comorbidities; abuse of alcohol or psychotropic drugs; seriously reduced eyesight or other sensory deficits that could affect the assessment of cognitive status; and Mini-Mental State Examination (MMSE) score of ≤ 24 and Frontal Assessment Battery (FAB) score of ≤ 11[13,14]
Summary
This study aims to evaluate late postoperative neurophysiological outcomes in patients after coronary artery bypass grafting (CABG). Postoperative cognitive dysfunction (POCD) is a decline in cognitive functions following surgery, characterized by impairment of attention, concentration, and memory that may have long-term implications[2]. Recent studies have demonstrated that early POCD occurs in almost 70% of patients undergoing coronary artery bypass grafting (CABG). Cognitive decline occurs in 30-50% of cases, affecting their long-term prognosis[1,3]. Persistent POCD affects the quality of life, leading to disability and social maladjustment[5,6]. It is associated with an increased risk of mortality during a seven-year follow-up[6]
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