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Statins in prevention of postoperative cognitive dysfunction in patients after cardiac surgery

https://doi.org/10.23946/2500-0764-2019-4-2-95-106

Abstract

On-pump CABG is commonly accompanied by the development of postoperative cognitive dysfunction considerably affecting the prognosis in this group of patients. However, there are no accepted guidelines on diagnostics and prevention of postoperative cognitive dysfunction. Here we review the incidence, mechanisms, and outcomes of postoperative cognitive dysfunction after coronary artery bypass graft surgery and highlight the benefits of statins for its prevention. We further provide evidence from national and international studies assessing the role of statins in the prevention of postoperative cognitive dysfunction.

About the Authors

O. V. Maleva
Research Institute for Complex Issues ofCardiovascular Diseases
Russian Federation

Dr. Olga V. Maleva - MD, PhD, Researcher, Laboratory for Neurovascular Pathology, Division of Atherosclerosis Research.

6, Sosnovy Boulevard, Kemerovo, 650002



O. A. Trubnikova
Research Institute for Complex Issues ofCardiovascular Diseases
Russian Federation

Dr. Olga A. Trubnikova - MD, DSc, Head of the Laboratory for Neurovascular Pathology, Division of Atherosclerosis Research.

6, Sosnovy Boulevard, Kemerovo, 650002



O. L. Barbarash
Research Institute for Complex Issues ofCardiovascular Diseases; Kemerovo State Medical University
Russian Federation

Prof. Olga L. Barbarash - MD, DSc, Professor, ChiefExecutive Officer, RICICD; Head of the Department ofCardiology and Cardiovascular Surgery, KSMU.

6, Sosnovy Boulevard, Kemerovo, 650002; 22a, Voroshilova Street, Kemerovo, 650056



References

1. Trubnikova OA, Maleva OV, Gruzdeva OV, Golovkin AS, Barbarash OL. The effect of statins on the severity of systemic inflammatory response syndrome in patients undergoing direct myocardial revascularization under extracorporeal circulation. Cardiology and Cardiovascular Surgery. 2013; 5: 32-37. Russian

2. Pomeshkina SA, Barbarash OL. Compliance with drug therapy in patients with coronary artery disease undergoing coronary artery bypass grafting. Siberian Medical Review. 2015; 85: 7578. Russian

3. Trubnikova OA, Tarasova IV, Artamonova AI, Syrova ID, Barbarash OL. Age as a risk factor for cognitive impairment after coronary artery bypass surgery. Korsakov Journal of Neurology and Psychiatry. 2011; 111 (8): 46-49. Russian

4. Bokeriia L.A., Kamchatnov P.R., Kluchnikov I.V., Alaverdyan A.G., Gusev E.I. Cerebrovascular disorders in patients with coronary bypass surgery. Korsakov Journal of Neurology and Psychiatry. 2008; 3: 90-94. Russian

5. Seines OA, Gottesman RF, Grega МА, Baumgartner WA, Zeger SL, McKhann GM. Cognitive and neurologic outcomes after coronary-artery bypass surgery. N Engl J Med. 2012; 366 (3): 250-257. doi: 10.1056/NEJMrall00109.

6. Tindle H, Belnap BH, Houck PR, Mazumdar S, Scheier MF, Matthews KA, et al. Optimism, response to treatment of depression, and rehospitalization after coronary artery bypass graft surgery. Psychosom Med. 2012; 74 (2): 200-207. doi: 10.1097/PSY.0b013e318244903f.

7. Doering LV, Cross R, Vredevoe D, Martinez-Maza O, Cowan MJ. Infection, depression, and immunity in women after coronary artery bypass: a pilot study of cognitive behavioral therapy. Altern Ther Health Med. 2007; 13 (3): 18-21.

8. Trubnikova OA, Tarasova IV, Mamontova AS, Syrova ID, Maleva OV, Barbarash OL. Structure of cognitive disorders and dynamics of bioelectric activity of the brain in patients after direct myocardial revascularization. Russian Journal of Cardiology. 2014; 112 (8): 57-62. Russian doi: 10.15829/1560-4071-2014-8-57-62.

9. Ebert AD, Walzer ТА, Huth C, Herrmann M. Early neurobehavioral disorders after cardiac surgery: a comparative analysis of coronary artery bypass graft surgery and valve replacement. J Cardiothorac Vase Anesth. 2001; 15 (1): 15-19.

10. Bruce KM, Yelland GW, Smith JA, Robinson SR. Recovery of cognitive function after coronary artery bypass graft operations. Ann Thorac Surg. 2013; 95 (4): 1306-1313. doi: 10.1016/j.athoracsur.2012.11.021.

11. Doering LV, Cross R, Vredevoe D, Martinez-Maza O, Cowan MJ. Infection, depression, and immunity in women after coronary artery bypass: a pilot study of cognitive behavioral therapy. Altern Ther Health Med. 2007; 13 (3): 18-21.

12. Abbasi SH, Mohammadinejad P, Shahmansouri N, Salehiomran A, Beglar AA, Zeinoddini A, et al. Simvastatin versus atorvastatin for improving mild to moderate depression in postcoronary artery bypass graft patients: A double-blind, placebo-controlled, randomized trial. J Affect Disord. 2015; 183: 149155. doi: 10.1016/j.jad.2015.04.049.

13. Krukow P. Neuropsychological dysfunctions in patients with cardiovascular system disorders and their possible implications in problem of medical non-adherence II Bulletin of Moscow State University. Psychology. 2012; 14 (3): 108-120. Russian

14. Monk TG, Weldon ВС, Garvan CW, Dede DE, van der Aa MT, Heilman KM, et al. Predictors of Cognitive Dysfunction after Major Noncardiac Surgery. Anesthesiology. 2008; 108 (1): 1830.

15. Tindle H, Belnap BH, Houck PR, Mazumdar S, et al. Optimism, response to treatment of depression, and rehospitalization after coronary artery bypass graft surgery. Psychosom Med. 2012. 74 (2): 200-207.

16. Szwed K, Bielinski M, Drozdz W, Pawliszak W, Hoffmann A, Anisimowicz L, et al. Cognitive dysfunction after cardiac surgery. Psychiatr Pol. 2012; 46 (3): 473-482.

17. Perani D., Abutalebi J. Bilingualism, dementia, cognitive and neural reserve. Curr Opin Neurol. 2015; 28 (6): 618-625. doi: 10.1097/WC0.0000000000000267.

18. Martins Da Silva A, Cavaco S, Moreira I, Bettencourt A, Santos E, Pinto C, et al. Cognitive reserve in multiple sclerosis: Protective effects of education. Mult Scler. 2015; 21 (10): 1312-1321. doi: 10.1177/1352458515581874.

19. Williamson JD, Launer LJ, Bryan RN, Coker LH, Lazar RM, Gerstein HC, et al. Cognitive function and brain structure in persons with type 2 diabetes mellitus after intensive lowering of blood pressure and lipid levels: a randomized clinical trial. Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes Investigators. JAMA Intern Med. 2014; 174 (3): 324333. doi: 10.1001/jamainternmed.2013.13656.

20. Wang C, Chan JS, Ren L, Yan JH. Obesity Reduces Cognitive and Motor Functions across the Lifespan. Neural Plast. 2016; 2016: 2473081. doi: 10.1155/2016/2473081.

21. Horie NC, Serrao VT, Simon SS, Gascon MR, Dos Santos AX, Zambone MA, et al. Cognitive effects of intentional weight loss in elderly obese individuals with mild cognitive impairment. J Clin Endocrinol Metab. 2016; 101 (3): 1104-1112. doi: 10.1210/jc.2015-2315.

22. Lund C, Hoi PK, Lundblad R, Fosse E, Sundet K, Tennoe B, et al. Comparison of cerebral embolization during off-pump and on-pump coronary artery bypass surgery. Ann Thorac Surg. 2003; 76 (3): 765-770.

23. Benito-Leon J, Louis ED, Vega S, Bermejo-Pareja F. Statins and cognitive functioning in the elderly: a population-based study. J Alzheimers Dis. 2010; 21 (1): 95-102. doi: 10.3233/JAD-2010-100180.

24. Barbarash OL, Kurguzova EM, Ivanov SV, Kazachek YaV, Bayrakova YuV, Avramenko OE, et al. Efficiency and safety of preoperative statin management in patients with CAD. Heart. 2011; 6: 315-320. Russian

25. Lomivorotov VV, Shmyrev VA, Ponomarev DN, Efremov SM, Shilova AN, Postnov VG. Influence of remote ischemic preconditioning on brain injury markers dynamics during cardiopulmonary bypass. Anesthesiology and Reanimatology. 2015;60(l):33-8. Russian

26. Hudetz JA, Gandhi SD, Iqbal Z, Patterson KM, Pagel PS. Elevated postoperative inflammatory biomarkers are associated with short- and medium-term cognitive dysfunction after coronary artery surgery. J Anesth. 2011; 25 (1): 1-9. doi: 10.1007/s00540-010-1042-y.

27. Kazmierski J., Banys A., Latek J., Bourke J., Jaszewski R. Raised IL-2 and TNF-a concentrations are associated with postoperative delirium in patients undergoing coronary-artery bypass graft surgery. Int Psychogeriatr. 2014; 26 (5): 845-855. doi: 10.1017/S1041610213002378.

28. Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: a report of the American College of Cardiology Foundation. Circulation 2011; 124: 652-735.

29. Parent MA, Hottman DA, Cheng S, Zhang W, McMahon LL, Yuan LL, et al. Simvastatin Treatment Enhances NMDAR-Mediated Synaptic Transmission by Upregulating the Surface Distribution of the GluN2B Subunit. Cell Mol Neurobiol. 2014; 34 (5): 693-705. doi: 10.1007/sl0571-014-0051-z.

30. Giannopoulos S, Katsanos AH, Tsivgoulis G, Marshall RS. Statins and cerebral hemodynamics. J Cereb Blood Flow Metab. 2012; 32 (11): 1973-1976. doi: 10.1038/jcbfm.2012.122.

31. Sierra S, Ramos MC, Molina P, Esteo C, Vazquez JA, Burgos JS. Statins as neuroprotectants: a comparative in vitro study of lipophilicity, blood-brain-barrier penetration, lowering of brain cholesterol, and decrease of neuron cell death. J Alzheimers Dis. 2011; 23 (2): 307-318. doi: 10.3233/JAD-2010-101179.

32. Domoki F, Kis B, Gaspar T, Snipes JA, Parks JS, Bari F, et al. Rosuvastatin induces delayed preconditioning against oxygen-glucose deprivation in cultured cortical neurons. Am J Physiol Cell Physiol. 2009; 296 (1): C97-105. doi: 10.1152/ajpcell.00366.2008.

33. Dereli Y, Ege E, Kurban S, Narin C, Sarigfll A, Yeniterzi M. Pre-operative atorvastatin therapy to decrease the systemic inflammatory response after coronary artery bypass grafting. J Int Med Res. 2008; 36 (6): 1248-1254.

34. Swiger KJ, Manalac RJ, Blumenthal RS, Blaha MJ, Martin SS. Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects. Mayo Clin Proc. 2013; 88 (11): 1213-1221. doi: 10.1016/j.mayocp.2013.07.013.

35. Nezic L, Skrbic R, Dobric S, Stojiljkovic MP, Satara SS, Milovanovic ZA, et al. Effect of simvastatin on proinflammatory cytokines production during lipopolysaccharide-induced inflammation in rats. Gen Physiol Biophys. 2009; 28 Spec No:119-126.

36. McGuinness B, Craig D, Bullock R, Malouf R, Passmore P. Statins for the prevention of dementia. Cochrane Database Syst Rev. 2014; 7: CD007514. doi: 10.1002/14651858.CD007514.pub3.

37. Pedroni SM, Gonzalez JM, Wade J, Jansen MA, Serio A, Marshall I, et al. Complement inhibition and statins prevent fetal brain cortical abnormalities in a mouse model of preterm birth. Biochim Biophys Acta 2014; 1842 (1): 107-115. doi: 10.1016/j.bbadis.2013.10.011.

38. Tramontina AC, Wartchow KM, Rodrigues L, Biasibetti R, Quincozes-Santos A, Bobermin L, et al. The neuroprotective effect of two statins: simvastatin and pravastatin on a streptozotocin-induced model of Alzheimer's disease in rats. J Neural Transm. 2011; 118 (11): 1641-1649. doi: 10.1007/s00702-011-0680-z.

39. Kozuki M, Kurata T, Miyazaki K, Morimoto N, Ohta Y, Ikeda Y, et al. Atorvastatin and pitavastatin protect cerebellar Purkinj cells in AD model mice and preserve the cytokines MCP-1 and TNF-a. Brain Res. 2011; 1388: 32-38. doi: 10.1016/j.brainres.2011.03.024.

40. Dong W, Vuletic S, Albers JJ. Differential effects of simvastatin and pravastatin on expression of Alzheimer's disease-related genes in human astrocytes and neuronal cells. J Lipid Res. 2009; 50 (10): 2095-2102. doi: 10.1194/jlr.M900236-JLR200.

41. Kumar A, Vashist A, Kumar P, Kaionia H, Mishra J. Protective effect of HMG CoA reductase inhibitors against running wheel activity induced fatigue, anxiety like behavior, oxidative stress and mitochondrial dysfunction in mice. Pharmacol Rep. 2012; 64 (6): 1326-1336.

42. Savoia C, Sisalli MJ, Di Renzo G, Annunziato L, Scorziello A. Rosuvastatin-induced neuroprotection in cortical neurons exposed to OGD/reoxygenation is due to nitric oxide inhibition and ERK1/2 pathway activation. Int J Physiol Pathophysiol Pharmacol. 2011; 3 (1): 57-64.

43. Famer D, Crisby M. Rosuvastatin reduces gliosis and the accelerated weight gain observed in WT and ApoE- mice exposed to a high cholesterol diet. Neurosci Lett. 2007; 419 (1): 68-73. doi: 10.1016/j.neulet.2007.03.055.

44. Sanchez-Aguilar M, Tapia-Perez JH, Sanchez-Rodrfguez JJ, Vinas-Rfos JM, Martfnez-Perez P, de la Cruz-Mendoza E, et al. Effect of rosuvastatin on cytokines after traumatic head injury. J Neurosurg. 2013; 118 (3): 669-675. doi: 10.3171/2012.12.JNS121084.

45. Schilling JM, Cui W, Godoy JC, Risbrough VB, Niesman IR, Roth DM, et al. Long-term atorvastatin treatment leads to alterations in behavior, cognition, and hippocampal biochemistry. Behav Brain Res. 2014; 267: 6-11. doi: 10.1016/j.bbr.2014.03.014.

46. Klopfleisch S, Merkler D, Schmitz M, Kloppner S, Schedensack M, Jeserich G, et al. Negative impact of statins on oligodendrocytes and myelin formation in vitro and in vivo. J Neurosci. 2008; 10; 28 (50): 13609-13614. doi: 10.1523/JNEUROSCI.2765-08.2008.

47. Huo XL, Min JJ, Pan CY, Zhao CC, Pan LL, Gui FF, et ai. Efficacy of lovastatin on learning and memory deficits caused by chronic intermittent hypoxia-hypercapnia: through regulation of NR2B-containing NMDA receptor-ERK pathway. PLoS One. 2014; 9 (4): e94278. doi: 10.1371/journai.pone.0094278.

48. Feldman HH, Doody RS, Kivipelto M, Sparks DL, Waters DD, Jones RW, et al. Randomized controlled trial of atorvastatin in mild to moderate Alzheimer disease: LEADe. Neurology. 2010; 23; 74 (12): 956-964. doi: 10.1212/WNL.0b013e3181d6476a.

49. Kaionia H, Kumar P, Kumar A. Comparative neuroprotective profile of statins in quinolinic acid induced neurotoxicity in rats. Behav Brain Res. 2011; 216 (1): 220-228. doi: 10.1016/j.bbr.2010.07.040.

50. Can OD, Uluptnar E, Ozkay UD, Yegin B, Oztflrk Y. The effect of simvastatin treatment on behavioral parameters, cognitive performance, and hippocampal morphology in rats fed a standard or a high-fat diet. Behav Pharmacol. 2012; 23 (5-6): 582-592. doi: 10.1097/FBP.0b013e328356c3f2.

51. Harrison RW, Ashton CH. Do cholesterol-lowering agents affect brain activity? A comparison of simvastatin, pravastatin, and placebo in healthy volunteers. Br J Clin Pharmacol. 1994; 37 (3): 231-236. doi: 10.1111/j.l365-2125.1994.tb04268.x.

52. Chuang CS, Lin CL, Lin MC, Sung FC, Kao CH. Decreased prevalence of dementia associated with statins: a national population-based study. Eur J Neurol. 2015; 22 (6): 912-918. doi: 10.1111/ene.l2402.

53. Vandresen-Filho S, Martins WC, Bertoldo DB, Mancini G, Herculano BA, de Bern AF, et al. Atorvastatin prevents cell damage via modulation of oxidative stress, glutamate uptake and glutamine synthetase activity in hippocampal slices subjected to oxygen/glucose deprivation. Neurochem Int. 2013; 62 (7): 948-955. doi: 10.1016/j.neuint.2013.03.002.

54. Fisher M, Moonis M. Neuroprotective effects of statins: evidence from preclinical and clinical studies. Curr Treat Options Cardiovasc Med. 2012; 14 (3): 252-259. doi: 10.1007/S11936-012-0174-9.

55. Chataway J, Schuerer N, Alsanousi A, Chan D, MacManus D, Hunter K, et al. Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial. Lancet. 2014; 28; 383 (9936): 2213-2221. doi: 10.1016/S0140-6736(13)62242-4.

56. Rondi S, Peddolla R, Venisetty RK. Neuro, cardio, and reno protective activities of rosuvastatin in streptozotocin-induced type 2 diabetic rats undergoing treatment with metformin and glimepiride. J Adv Pharm Technol Res. 2014; 5 (2): 78-83. doi: 10.4103/2231-4040.133429.

57. van Vliet P. Cholesterol and late-life cognitive decline. J Alzheimers Dis. 2012;30 Suppl 2:S147-62. doi: 10.3233/JAD-2011-111028.

58. Rojas-Fernandez CH, Goldstein LB, Levey AI, Taylor BA, Bittner V, The National Lipid Association's Safety Task Force. An assessment by the Statin Cognitive Safety Task Force: 2014 update. J Clin Lipidol. 2014; 8 (3 Suppl): S5-16. doi: 10.1016/j.jacl.2014.02.013.

59. Brass LM, Alberts MJ, Sparks L; National Lipid Association Statin Safety Task Force Neurology Expert Panel. An assessment of statin safety by neurologists. Am J Cardiol. 2006; 97 (8A): 86C-88C.

60. Liakopoulos OJ, Choi YH, Haldenwang PL, Strauch J, Wittwer T, Dorge H, et al. Impact of preoperative statin therapy on adverse postoperative outcomes in patients undergoing cardiac surgery: a meta-analysis of over 30,000 patients. Eur Heart J. 2008; 29 (12): 1548-1559. doi: 10.1093/eurheartj/ehnl98.

61. Griffiths H, Irundika D, Lip G, Spickett C, Polidori C. Oxidised LDL lipids, statins and a blood-brain barrier. Free Radic Biol Med. 2014; 75 Suppl 1: S15-6. doi: 10.1016/j.freeradbiomed.2014.10.591.

62. Kulik A, Brookhart MA, Levin R, Ruel M, Solomon DH, Choudhry NK. Impact of statin use on outcomes after coronary artery bypass graft surgery. Circulation. 2008; 28; 118 (18): 1785-1792. doi: 10.1161/CIRCULATIONAHA.108.799445.

63. Kumar A, Sharma N, Mishra J, Kaionia H. Synergistical neuroprotection of rofecoxib and statins against malonic acid induced Huntington’s disease like symptoms and related cognitive dysfunction in rats. Eur J Pharmacol. 2013; 709 (13): 1-12. doi: 10.1016/j.ejphar.2013.03.042.

64. Betteridge DJ, Carmena R. The diabetogenic action of statins - mechanisms and clinical implications. Nat Rev Endocrinol. 2016; 12 (2): 99-110. doi: 10.1038/nrendo.2015.194.

65. Lorza-Gil E, Salerno AG, Wanschel AC, Vettorazzi JF, Ferreira MS, Rentz T, et al. Chronic use of pravastatin reduces insulin exocytosis and increases p-cell death in hypercholesterolemic mice. Toxicology. 2016; 344-346: 42-52. doi: 10.1016/j.tox.2015.12.007.

66. Cho Y, Choe E, Lee YH, Seo JW, Choi Y, Yun Y, et al. Risk of diabetes in patients treated with HMG-CoA reductase inhibitors. Metabolism. 2015; 64 (4): 482-488. doi: 10.1016/j.metabol.2014.09.008.

67. Ghodke RM, Tour N, Devi K. Effects of statins and cholesterol on memory functions in mice. Metab Brain Dis. 2012; 27 (4): 443-451. doi: 10.1007/sll011-012-9343-5.

68. Kesim M, Yulug E, Kadioglu M, Erkoseoglu I, Aykan DA, Kalyoncu N1, et al. The effect of simvastatin on picrotoxin-induced seizure in mice. J Pak Med Assoc. 2012; 62 (11): 11871191.

69. Dafla Y, Singh N, Jaggi AS, Singh D. Memory restorative role of statins in experimental dementia: an evidence of their cholesterol dependent and independent actions. Pharmacol Rep. 2010; 62 (5): 784-796.

70. Trubnikova OA, Mamontova AA, Tarasova IV, Maleva OV, Kuzmina AA, Barbarash OL. Association of cognitive impairments with carbohydrate and lipid metabolic parameters in patients with type 2 diabetes mellitus to undergo coronary bypass surgery. Therapeutic Archive. 2015; 87 (1): 69-75. Russian

71. Lorza-Gil Е, Salerno AG, Wanschel АС, Vettorazzi JF, Ferreira MS, Rentz T, et al. Chronic use of pravastatin reduces insulin exocytosis and increases p-cell death in hypercholesterolemic mice. Toxicology. 2016; 344-346: 42-52. doi: 10.1016/j.tox.2015.12.007.

72. Avadhani R, Fowler K, Barbato C, Thomas S, Wong W, Paul C, et al. Glycemia and cognitive function in metabolic syndrome and coronary heart disease. Am J Med. 2015; 128 (1): 46-55. doi: 10.1016/j.amjmed.2014.08.025.


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Maleva O.V., Trubnikova O.A., Barbarash O.L. Statins in prevention of postoperative cognitive dysfunction in patients after cardiac surgery. Fundamental and Clinical Medicine. 2019;4(2):95-106. (In Russ.) https://doi.org/10.23946/2500-0764-2019-4-2-95-106

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