Risk factors for cognitive decline in patients in long-term period of coronary artery bypass grafting

Aim. To identify risk factors leading to a cognitive decline 5–7 years after CABG, and to develop a model for predicting the development of POCD in patients in the long-term period of CABG.
Materials and methods. The observational prospective study included 146 patients; average follow-up period was 6.4 years. The patients underwent general clinical, neurological, and instrumental examinations 3–5 days before and 5–7 years after surgery. Neuropsychological testing included assessment of psychomotor and executive functions, attention, and short-term memory. The method of binary logistic regression was used to build a predictive model.
Results. Cognitive decline was detected in 67 patients (45.9%) at 5–7 years after CABG. The presence of carotid artery (CA) stenosis (p = 0.01), smoking (p = 0.005), reduced left ventricular ejection fraction (p = 0.039), and high triglyceride levels (p = 0.011) was associated with a cognitive decline. The model`s sensitivity was 0.61 and specificity was 0.82, indicating a good quality. Results indicate that the model can accurately predict the presence or absence of cognitive decline with a high level of accuracy.
Conclusion. Five to seven years following CABG, 46% of patients experienced a decrease in cognitive functions, manifested in the form of neurodynamic dysfunction, as well as deterioration of short-term memory. The factors included in the prognostic model were CA stenosis, reduced left ventricular ejection fraction, and high triglyceride levels, as well as smoking. The findings indicate the need to improve approaches to postoperative follow-up of patients who have undergone cardiac surgery in order to minimize adverse neurological consequences.

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