“The neuropsychological approach should be mandatory in all patients with acute coronary syndrome, such as myocardial infarction, in order to identify cognitive deficits and to implement neuropsychological rehabilitation programs aimed at reducing the impact of the disease on cognition.” The conclusion is from a Portuguese study coordinated by Bruno Peixoto, a researcher from CINTESIS and a CESPU professor, with the objective of calculating the prevalence of neurocognitive deficits in a group of patients undergoing cardiac rehabilitation in a hospital after an acute coronary syndrome. This is one of the most prevalent cardiovascular pathologies with higher mortality, including acute myocardial infarction.
Another objective of this study was to establish the relationship between cognitive functioning after illness and a number of sociodemographic variables (age, schooling and profession), clinical (blood pressure) and emotional (such as anxiety).
In this paper, recently published in the Journal of Cardiovascular and Thoracic Research, the conclusion presented is that the percentage of cognitive dysfunction after an acute coronary syndrome is “considerably high.”
The data indicate that 85% of patients have some degree of cognitive impairment, a prevalence much higher than what is found in other studies of this kind (between 10.51 and 66.8%). Of these, about half (49.1%) have deficits considered to be serious.
The areas most affected by acute cardiac syndrome are verbal fluency and memory. In this population, 84.8% of the patients present some verbal fluency impairment, which is considered to be serious in about 50% of the cases. In addition, 60.3% have memory deficits. Only 26% present language impairment.
Age is one of the factors most related to the appearance of neurocognitive deficits after a coronary syndrome. That is like saying that the older you are, the greater the likelihood of suffering some type of deficit.
Memory deficit, on the other hand, appears clearly related to smoking. There is even a relationship between the number of cigarettes smoked daily before the coronary event and the severity with which memory is affected.
And verbal fluency is associated, in this study, with eduaction, “a known factor of cognitive reserve”. It is thus confirmed that greater education protects patients who have suffered a coronary event from neurocognitive impairment.
Although they account for a lower percentage of patients, language problems following an acute coronary syndrome appear to be related to factors such as diastolic blood pressure and the profession, and so-called intellectual professions are the least affected.
With regard to emotional factors, patients with more anxiety are also those with less healthy behaviors and, therefore, with more cardiovascular risk factors.
In view of the high prevalence of cognitive problems in these patients, Bruno Peixoto considers that a neurocognitive evaluation should be carried out systematically to detect possible deficits and start a rehabilitation program as soon as possible, thus reducing the impact of these diseases on the population.