Cognitive Impairment Prevalent Among Patients Hospitalized for Myocardial Infarction

A high prevalence of previously undiagnosed cognitive impairment has been reported among patients hospitalized following myocardial infarction (MI), with accumulating evidence suggesting a link between coronary artery disease and the occurrence of cognitive impairment.

A study was conducted among patients from Poznań, Poland, who were hospitalized due to MI. Results of the study were presented at the American College of Cardiology (ACC) 71st Annual Scientific Session & Expo, from April 2-4, 2022, in Washington, DC.

Researchers sought to evaluate the incidence of cognitive dysfunction among individuals following MI and to identify factors that might be involved. According to Dominika Kasprzak, MD, a cardiologist at J. Strus Hospital in Poznań, Poland, and the lead author of the study, “We found a very high prevalence of previously undiagnosed cognitive impairment among patients hospitalized due to myocardial infarction. This impairment can be both temporary and permanent, and some patients develop impairment after a delay of several months.”

A total of 220 individuals who were hospitalized because of MI were assessed. Cognitive function was evaluated at baseline and 6 months later with use of the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT).

At baseline, cognitive impairment was detected in 40.5% of participants with the MMSE and in 34.5% with the CDT. Significant improvement in the prevalence of cognitive impairment — decreases to 33.6% with the MMSE and to 26.8% with the CDT — was seen after 6 months.

Overall, 46% of patients with disorders that were originally diagnosed based on the MMSE obtained a correct test result within 6 months of observation, whereas 43.4% still presented with disorders. In addition, 11% of individuals with normal MMSE results during the initial hospitalization were diagnosed with cognitive impairment after 6 months. Similar results were observed with the CDT: 56.6% of patients performed the test correctly following 6 months of observation, whereas 43.4% continued to demonstrate dysfunction. Cognitive dysfunction was observed to persist beyond 6 months in 11.8% of patients, despite an initial correct test result.

Sleep disturbances during the peri-infarction period were identified via the MMSE significantly more often in patients with transient cognitive impairment (P =.03). Compared with individuals without cognitive impairment, those with permanent cognitive disorders as determined by the CDT were older (58.6 years vs 64.1 years, respectively; P =.002), had lower ejection fraction (44.8% vs 49.3%, respectively; P =.009), and had higher levels of brain natriuretic peptide (P =.002) and troponin (P =.01).

The researchers concluded that cognitive impairment occurring in relation to MI can be both temporary and permanent. Patients who experience MI should be monitored regularly for the early detection of changes in cognitive function and implementation of appropriate management strategies.

Reference

Kasprzak D, Rzeźniczak J, Ganowicz T, et al.  Cognitive impairment after myocardial infarction. Presented at: American College of Cardiology 71st Annual Scientific Session & Expo; April 2-4, 2022; Washington, DC. Abstract Number: 22-A-9629-ACC

Heart Attack Survivors May Be at Greater Risk of Mental Decline. News Release. Washington, DC. March 24, 2022.