Long-term cognitive decline and mortality after carotid endarterectomy

• Published in: Clinical neurology and neurosurgery 2020-07, Vol.194, p.105823-105823, Article 105823
• Main Authors: Thirumala, Parthasarathy D., Reddy, Rajiv P., Lopez, Oscar L., Chang, Yue-Fang, Becker, James T., Kuller, Lewis H.
• Format: Article
• Language: English
• Subjects: Age; Blood pressure; Carotid arteries; Carotid endarterectomy; Cerebrovascular disease; Cognitive ability; Cognitive decline; Flow velocity; Gender; Heart surgery; Hypotheses; Lipoproteins; Mortality; Neurology; Risk factors; Stroke; Veins & arteries
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2020.105823

•Patients who underwent CEA score lower on 3MSE and DSST testing in the long term.•Lower 3MSE and DSST scores are linked with increased risk of mortality.•Mortality in the CHS cohort was higher in participants who underwent CEA.•Long term studies to evaluate cognitive dysfunction during CEA are necessary. To date no studies have evaluated long term cognitive decline after carotid endarterectomy (CEA). We evaluated whether participants who had CEA were at increased risk of cognitive decline over participants who didn’t undergo CEA. The patients in the study were participants in the Cardiovascular Health Study (CHS), a study of 5201 men and women over the age of 65 who were recruited from four communities (Pittsburgh, Pennsylvania; Sacramento, California; Winston-Salem, North Carolina; Hagerstown, Maryland) in 1988–89. The outcomes measured were 1) Decline in 3MSE and digit symbol substitution test (DSST) scores after CEA compared to before CEA. 2) All-cause mortality in CHS cohort among participants who did and did not have CEA. CEA patients had significantly greater annual decrease in the DSST scores −2.43 (SD 4.21) compared to those who did not have a CEA −1.1 (SD 2.57) (p