Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization

Irina Tarasova; Olga Trubnikova; Darya S Kupriyanova; Olga Maleva; Irina Syrova; Irina Kukhareva; Anastasia Sosnina; Roman Tarasov; Olga Barbarash

doi:10.3389/fnhum.2023.996359

Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization

Front Hum Neurosci. 2023 Apr 12:17:996359. doi: 10.3389/fnhum.2023.996359. eCollection 2023.

Authors

Irina Tarasova¹, Olga Trubnikova¹, Darya S Kupriyanova¹, Olga Maleva¹, Irina Syrova¹, Irina Kukhareva¹, Anastasia Sosnina¹, Roman Tarasov², Olga Barbarash³

Affiliations

¹ Department of Clinical Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.
² Department of Cardiac and Vascular Surgery, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.
³ Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.

Abstract

Background: On-pump coronary artery bypass grafting (CABG) is associated with a high risk of neurological complications in patients with severe carotid stenosis. Moreover, early postoperative cognitive dysfunction (POCD) incidence remains high in patients undergoing simultaneous coronary and carotid surgery. Recent studies have shown that even moderate carotid stenosis (≥50%) is associated with postoperative cognitive decline after CABG. Data on brain health in the postoperative period of simultaneous coronary and carotid surgery are limited.

Objectives: This study aimed to analyze early postoperative changes in the cognitive function and patterns of brain electrical activity in patients after simultaneous coronary and carotid artery revascularization.

Materials and methods: Between January 2017 and December 2020, consecutive patients were assigned to on-pump CABG with or without carotid endarterectomy (CEA) according to clinical indications. An extended neuropsychological and electroencephalographic (EEG) assessment was performed before surgery and at 7-10 days after CABG or CABG + CEA.

Results: A total of 100 patients were included [median age 59 (55; 65), 95% men, MMSE 27 (26; 28)], and among these, 46 underwent CEA. POCD was diagnosed in 29 (63.0%) patients with CABG + CEA and in 32 (59.0%) patients with isolated CABG. All patients presented with a postoperative theta power increase. However, patients with CABG + right-sided CEA demonstrated the most pronounced theta power increase compared to patients with isolated CABG.

Conclusion: The findings of our study show that patients with CABG + CEA and isolated CABG have comparable POCD incidence; however, patients with CABG + right-sided CEA presented with lower brain activity.

Keywords: brain electrical activity; carotid endarterectomy; coronary artery bypass grafting; postoperative cognitive dysfunction; simultaneous revascularization.

Grants and funding

This study was supported by the Federal State Ministry of Science and Education of the Russian Federation (Fundamental research topic No. 122012000364-5, dated January 20, 2022). The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.