Increased Carotid Intima-Media Thickness was not Associated With Cognitive Dysfunction After Off-Pump Coronary Surgery in Older Adult Patients Without Carotid Stenosis
| Autor: | Hye Bin Kim, Byongnam Jun, Young Lan Kwak, Jae Kwang Shim, Bora Lee, Kwang Sup Kim |
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| Rok vydání: | 2022 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Coronary Artery Bypass Off-Pump 030204 cardiovascular system & hematology Carotid Intima-Media Thickness law.invention 03 medical and health sciences Coronary artery bypass surgery 0302 clinical medicine Risk Factors law medicine.artery Internal medicine Cardiopulmonary bypass medicine Humans Carotid Stenosis Cognitive Dysfunction Common carotid artery Aged Off-pump coronary artery bypass business.industry Montreal Cognitive Assessment General Medicine medicine.disease Obstructive lung disease Treatment Outcome 030228 respiratory system Intima-media thickness Cardiology Female Surgery Cardiology and Cardiovascular Medicine business Postoperative cognitive dysfunction |
| Zdroj: | Seminars in Thoracic and Cardiovascular Surgery. 34:112-121 |
| ISSN: | 1043-0679 |
| DOI: | 10.1053/j.semtcvs.2021.03.004 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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