Cognitive decline and ischemic microlesions after coronary catheterization. A comparison to coronary artery bypass grafting

BackgroundPostinterventional cognitive dysfunction (PICD) is a known complication of coronary artery bypass grafting (CABG). However, it is largely unknown whether PICD occurs after coronary catheterization.MethodsNeuropsychologic data were obtained from 37 patients who received coronary catheterization and 47 patients who underwent elective CABG at baseline and 3 months after the interventions. The outcomes were contrasted to 33 healthy volunteers, using analysis of covariance with baseline scores as covariates. Cerebral magnetic resonance imaging with diffusion-weighted imaging (DWI) sequences was performed in 30 catheter and 39 CABG patients 2 to 4 days after the procedures.ResultsThe rate of acute ischemic lesions amounted to 3.3% in the catheter group and to 17.9% in the CABG group. Postinterventional cognitive dysfunction was detected in 2 (of 10) tests in the catheter group as compared with the healthy controls (verbal memory: total recall, t = −2.61 (P = .005) and nonverbal memory, t = −2.60 [P = .005]). The CABG group showed PICD in 7 of 10 tests as compared with the healthy controls (statistics ranging from t = −1.95 [P = .027] to t = −5.14 [P < .001]). Scores of depression/anxiety and health-related quality of life were not associated with PICD (P > .05).ConclusionsAs compared with CABG, PICD and cerebral lesions appear to be substantially milder after coronary catheter intervention, but not negligible.