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Would Heart Procedures Lead To Cognitive Decline?
The doctor will probably start with medications to try clear the clogged or hardened arteries. When this does not work, the doctor will then suggest balloon angioplasty and stenting. But if the patient has multiple areas of coronary artery narrowing or blockage, the doctor would surely recommend coronary artery bypass graft surgery (CABG). Researchers from Justus Liebig University in Giessen reported in the October 2011’s issue of ‘American Heart Journal’ that patients who had CABG and those who underwent balloon angioplasty and stenting showed declines in thinking and memory skills a few months after the procedures. Such phenomenon, which is known as Postinterventional Cognitive Dysfunction (PICD), is the most frequent complication of CABG. In the past, it is widely assumed that the risk of having neurologic side effects or cognitive decline would be lower for coronary catheterization like angioplasty, though it is largely unknown if PCID occurs after coronary catheterization.
Cognition refers to thinking skills, and intellectual skills that allow one to acquire, perceive, understand and respond to information. It includes abilities to pay attention, remember, process information, solve problems, organize and reorganize information, communicate and act upon information. A person can function in his or her environment only if all these abilities can work in a close and interdependent manner. Cognitive skills can be measured. The German study involved 37 heart patients undergoing angioplasty and 47 patients getting CABG. Most of these patients aged between 60s and early 70s. The participants completed a series of thinking and memory tests, which was designed to measure how well they could come up with or remember certain words, symbols and pictures. The test was done before and 3 months after the surgeries. By comparing the changes in the test scores with those from another 33 healthy volunteers, a drop in score on 2 out of the 10 tests was noted for patients who underwent angioplasty, and the scores of patients who got CABG declined on 7 out of the 10 tests. However, it was not clear how much these cognitive changes could really affect people in their everyday lives. The findings also did not really prove it was the procedures themselves that cause memory decline. It is possible that the same patient who had atherosclerosis in the heart also had it in the brain, which could cause the problems mentioned. Meanwhile, patients who were treated with CABG are frequently in a worse health state than those who underwent angioplasty because the former had more blockages. It could be the severity of the atherosclerosis that caused the cognitive decline rather than the procedures themselves. This is certainly debatable. Some cardiothoracic surgeons in the United States argued that the risks of cognitive decline after CABG depend largely on how the procedure is done. It is very likely that the doctors who performed the German surgeries might not have used the best techniques to protect patients against these risks. According to them, the newest technology enables the surgeons to get their patients through the procedures in great shape and with no mortality. Heart patients should not be afraid to question their surgeons about the precautious steps they are taking to protect the brain during the procedures. In fact, with a good surgeon performing at a good hospital, chance that the patient would have thinking and memory problems because of CABG should not be greater than 1 in 20.
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