دورية أكاديمية
أعرض في EDS

Acute Myocardial Infarction and Risk of Cognitive Impairment and Dementia: A Review.

التفاصيل البيبلوغرافية
العنوان: Acute Myocardial Infarction and Risk of Cognitive Impairment and Dementia: A Review.
المؤلفون: Thong EHE; Internal Medicine Residency, National University Health System, Singapore 119074, Singapore., Quek EJW; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore., Loo JH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore., Yun CY; Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore., Teo YN; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore., Teo YH; Internal Medicine Residency, National University Health System, Singapore 119074, Singapore., Leow AST; Internal Medicine Residency, National University Health System, Singapore 119074, Singapore., Li TYW; Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore., Sharma VK; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore., Tan BYQ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore., Yeo LLL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore., Chong YF; Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore., Chan MY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore., Sia CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore.
المصدر: Biology [Biology (Basel)] 2023 Aug 21; Vol. 12 (8). Date of Electronic Publication: 2023 Aug 21.
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: MDPI Country of Publication: Switzerland NLM ID: 101587988 Publication Model: Electronic Cited Medium: Print ISSN: 2079-7737 (Print) Linking ISSN: 20797737 NLM ISO Abbreviation: Biology (Basel) Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel, Switzerland : MDPI, 2012-
مستخلص: Cognitive impairment (CI) shares common cardiovascular risk factors with acute myocardial infarction (AMI), and is increasingly prevalent in our ageing population. Whilst AMI is associated with increased rates of CI, CI remains underreported and infrequently identified in patients with AMI. In this review, we discuss the evidence surrounding AMI and its links to dementia and CI, including pathophysiology, risk factors, management and interventions. Vascular dysregulation plays a major role in CI, with atherosclerosis, platelet activation, microinfarcts and perivascular inflammation resulting in neurovascular unit dysfunction, disordered homeostasis and a dysfunctional neurohormonal response. This subsequently affects perfusion pressure, resulting in enlarged periventricular spaces and hippocampal sclerosis. The increased platelet activation seen in coronary artery disease (CAD) can also result in inflammation and amyloid-β protein deposition which is associated with Alzheimer's Dementia. Post-AMI, reduced blood pressure and reduced left ventricular ejection fraction can cause chronic cerebral hypoperfusion, cerebral infarction and failure of normal circulatory autoregulatory mechanisms. Patients who undergo coronary revascularization (percutaneous coronary intervention or bypass surgery) are at increased risk for post-procedure cognitive impairment, though whether this is related to the intervention itself or underlying cardiovascular risk factors is debated. Mortality rates are higher in dementia patients with AMI, and post-AMI CI is more prevalent in the elderly and in patients with post-AMI heart failure. Medical management (antiplatelet, statin, renin-angiotensin system inhibitors, cardiac rehabilitation) can reduce the risk of post-AMI CI; however, beta-blockers may be associated with functional decline in patients with existing CI. The early identification of those with dementia or CI who present with AMI is important, as subsequent tailoring of management strategies can potentially improve outcomes as well as guide prognosis.
Competing Interests: The authors declare no conflict of interest.
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معلومات مُعتمدة: NMRC/MOH-001080 National Medical Research Council
فهرسة مساهمة: Keywords: acute coronary syndrome; acute myocardial infarction; cognitive impairment; coronary artery bypass surgery; coronary artery disease; dementia; heart failure; percutaneous coronary intervention
تواريخ الأحداث: Date Created: 20230826 Latest Revision: 20230828
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10452707
DOI: 10.3390/biology12081154
PMID: 37627038
قاعدة البيانات: MEDLINE
الوصف
تدمد:2079-7737
DOI:10.3390/biology12081154