New Study Found High Prevalence of Undiagnosed Cognitive Impairment After Myocardial Infarction

Dominika Kasprzak, MD
Image courtesy of ACC

Approximately 1 in 3 patients hospitalized due to myocardial infarction (MI) showed significant mental decline in the days and months following their MI, according to a study presented at the American College of Cardiology’s (ACC) 71st Annual Scientific Session, held April 2-4, 2022.

“It is important to monitor patients regularly to detect changes in cognitive function early and to be able to implement appropriate management,” wrote study authors led by Dominika Kasprzak, MD, cardiologist, J. Strus Hospital, Poznań, Poland.

Kasprzak and colleagues aimed to assess the incidence of cognitive dysfunction in persons after MI and to identify any influencing factors. The team analyzed 220 patients hospitalized due to MI in Poznań, Poland. Cognitive function was assessed as baseline and 6 months later using the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT), which assess an individual’s thinking, memory, and ability to perform basic tasks.

At baseline, cognitive impairment (CI) was found in 40.5% of respondents using the MMSE and 34.5% using the CDT. After 6 months, “significantly better” results were recorded in both tests, and the prevalence decreased to 33.6% (MMSE) and 26.8% (CDT), according to the study abstract.

Also, 46% (n=41) of participants with disorders initially diagnosed according to the Modified Mini-Mental State test got a correct test result after 6 months of observation, while 54% (n=48) presented a permanent deficit. In 11% of patients with normal MMSE results during the first hospitalization, CI was diagnosed after 6 months. Similar results were obtained with the CDT: 56.6% (n=43) obtained the correct result after 6 months, while 43.4% (n=3) presented a permanent deficit.

In 11.8% (n=26) of the participants, CI was observed after 6 months, despite the initially correct result, according to researchers.

Compared to participants without CI during observation, those with permanent CI according to the CDT were significantly older (64.1 years vs 58.6 years; p=0.002), had a lower ejection fraction (44.8 vs 49.3; p=0.009), and had a higher level of brain natriuretic peptide (0.002) and troponin (p=0.01).

“Cognitive deficits, such as memory loss or not being able to recognize a loved one, can be even more important for our patients than their cardiovascular disease,” said Kasprzak in an ACC press release.“We need to monitor our patients regularly to detect changes in their functioning, not only in the heart but also in the brain.”

Investigators are currently examining data from a larger follow-up study to further investigate cognitive trends after MI and factors that contribute to these effects. In addition, the team plans to develop a more efficient assessment tool that cardiologists can use to screen for CI during routine follow-up visits.

Kasprzak will present the study, “Cognitive Impairment After Myocardial Infarction,” on Sunday, April 3, at 11:30 a.m. ET / 15:30 UTC in Ischemic Heart Disease Moderated Poster Theater 6, Hall C.