Comparative analysis of clinical and psychosocial characteristics of patients with different dynamics of cognitive functioning after coronary artery bypass grafting

Psychological aspects as compared to the technological part of direct myocardial revascularization and its consequences for cognitive functioning, which in turn affect the compliance and quality of life of patients, have not been enough studied yet. In this regard, the purpose of the study was to analyze the clinical and psychosocial characteristics of patients with coronary heart disease (CHD) with different dynamics of cognitive functions in the process of rehabilitation after coronary artery bypass grafting (CABG). A new method for the mathematical determination of cognitive dynamics, namely, the assessment of the improvement and deterioration of cognitive functioning after open-heart surgery was proposed. A total of 118 patients with coronary artery disease were examined. Among them there were 80.5% of men and 19.5% of women; mean age 59.86 ± 7.31 years. The study was conducted using the clinical-psychological method and the developed complex of patho- and neuropsychological methods for assessing various spheres of cognitive functioning. It was shown that patients with worse cognitive dynamics after CABG at the preoperative stage tend to have more frequent atherosclerosis of the brachiocephalic arteries, a complication of the early postoperative period in the form of postpericardiotomy syndrome, as well as burdened heredity of cardiovascular diseases. At the same time, a shorter aortic clamping time and the duration of use of cardiopulmonary bypass was recorded during the surgery in patients with cognitive impairment. A comparative analysis of the psychosocial characteristics of patients indicates significant differences in understanding the causes of the development of the underlying cardiovascular disease and the consequences of CABG in patients of both groups studied: patients with impaired cognitive functioning have a lower treatment adherence (compliance), and they tend to evaluate the upcoming operation as a negative life event.

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