Asymptomatic carotid stenosis and cognitive impairment.

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Surgery Pub Date : 2023-04-01 DOI:10.23736/S0021-9509.23.12620-6

Kosmas I Paraskevas, Dimitri P Mikhailidis, Francesco Spinelli, Gianluca Faggioli, Luca Saba, Mauro Silvestrini, Alexei Svetlikov, Francesco Stilo, Rodolfo Pini, Piotr Myrcha, Vincenzo DI Lazzaro, Pier L Antignani, Pavel Poredos, Gaetano Lanza

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引用次数: 4

Abstract

Introduction: The aim of this review was to assess the evidence supporting an association between asymptomatic carotid stenosis (ACS) with impaired cognitive function due to chronic cerebral hypoperfusion and/or silent cerebral embolization.

Evidence acquisition: PubMed/Medline, Embase and the Cochrane databases were searched up to December 1, 2022 to identify studies focusing on the association between ACS and cognitive function, as well as the mechanisms involved.

Evidence synthesis: A total of 49 studies were identified. The evidence supports an association between ACS and progressive cognitive deterioration. The mechanisms involved in the cognitive decline associated with ACS include cerebral hypoperfusion and silent cerebral embolization. Irrespective of the mechanism involved, severe ACS is associated with a progressive decline in several aspects of cognitive function, including global cognition, memory and executive function.

Conclusions: Patients with ACS are at increased risk of developing a progressive decline in their cognitive function. The evidence from the present systematic review suggests that it may be inappropriate to consider ACS patients developing cognitive dysfunction as "asymptomatic". Besides stroke, myocardial infarction and death rates, future studies should include evaluation of cognitive function as part of their outcomes.

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无症状颈动脉狭窄和认知障碍。

本综述的目的是评估无症状颈动脉狭窄(ACS)与慢性脑灌流不足和/或无症状脑栓塞导致的认知功能受损之间的关联证据。证据获取:检索截至2022年12月1日的PubMed/Medline、Embase和Cochrane数据库，以确定关注ACS与认知功能之间关联的研究，以及相关机制。证据综合:共确定了49项研究。证据支持ACS与进行性认知退化之间的关联。与ACS相关的认知能力下降的机制包括脑灌注不足和无症状脑栓塞。无论涉及的机制如何，严重的ACS与认知功能的几个方面的进行性下降有关，包括全局认知、记忆和执行功能。结论:ACS患者认知功能进行性下降的风险增加。本系统综述的证据表明，将ACS患者的认知功能障碍视为“无症状”可能是不恰当的。除了中风、心肌梗死和死亡率外，未来的研究还应包括评估认知功能作为其结果的一部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Surgery 医学-外科

CiteScore

2.50

自引率

7.10%

发文量

204

审稿时长

4-8 weeks

期刊介绍： The Journal of Cardiovascular Surgery publishes scientific papers on cardiac, thoracic and vascular surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, therapeutical notes, special articles and letters to the Editor. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (www.icmje.org). Articles not conforming to international standards will not be considered for acceptance.