BACKGROUND Cognitive impairment may limit the uptake of secondary prevention in acute coronary syndrome patients, but is poorly understood, including in cardiac rehabilitation participants. AIM The aim of this study was to explore cognitive impairment in relation to psychological state in acute coronary syndrome patients over the course of cardiac rehabilitation and follow-up. METHODS Acute coronary syndrome patients without diagnosed dementia were assessed on verbal learning, processing speed, executive function and visual attention, at cardiac rehabilitation entry, completion and follow-up and scores adjusted using normative data. The hospital anxiety and depression scale measured psychological state. RESULTS Participants (n = 40) had an average age of 66.2 (±8.22) years and were 70% men. Mild cognitive impairment occurred at cardiac rehabilitation entry in single 62.5% and multiple 22.5% domains but was significantly less prevalent by cardiac rehabilitation completion (52.5% and 15.0%) and follow-up (32.5% and 7.0%). Domains most often impaired were verbal learning (52.5%) and processing speed (25.6%), again decreasing significantly with time (verbal learning cardiac rehabilitation completion 42.5%, follow-up 22.5%; processing speed cardiac rehabilitation completion 15.0%, follow-up 15.0%). A small group of patients had persistent multiple domain cognitive impairment. At cardiac rehabilitation entry patients with cognitive impairment in processing speed, a single domain or multiple domains had more depression, and patients with cognitive impairment in executive function had more depression and anxiety. CONCLUSIONS At cardiac rehabilitation entry, mild cognitive impairment is very common in post-acute coronary syndrome patients and worse in patients who have depression or anxiety symptoms. Cognitive impairment decreases significantly by cardiac rehabilitation follow-up. A small proportion of patients has persistent, multiple domain cognitive impairment flagging potential long-term changes and the need for further investigations and cognitive rehabilitation.

中文翻译：

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急性冠脉综合征患者的认知障碍和心理状态：心脏康复进入、完成和随访的前瞻性描述性研究

背景认知障碍可能会限制急性冠状动脉综合征患者二级预防的使用，但人们对此知之甚少，包括在心脏康复参与者中。目的 本研究旨在探讨急性冠脉综合征患者在心脏康复和随访过程中认知障碍与心理状态的关系。方法对未确诊为痴呆的急性冠脉综合征患者进行语言学习、处理速度、执行功能和视觉注意力、心脏康复治疗、完成和随访时的评估，并使用规范数据调整分数。医院焦虑抑郁量表测量心理状态。结果 参与者 (n = 40) 的平均年龄为 66.2 (±8.22) 岁，男性占 70%。轻度认知障碍发生在单次心脏康复治疗的 62.5% 和多个 22.5% 领域，但在心脏康复完成（52.5% 和 15.0%）和随访（32.5% 和 7.0%）时发生率显着降低。最常受损的领域是语言学习（52.5%）和处理速度（25.6%），随着时间的推移再次显着下降（语言学习心脏康复完成率 42.5%，随访 22.5%；处理速度心脏康复完成 15.0%，随访15.0%）。一小部分患者有持续的多域认知障碍。心脏康复入门时，处理速度认知障碍患者，单域或多域抑郁症较多，执行功能认知障碍患者抑郁、焦虑较多。结论 在心脏康复阶段，轻度认知障碍在急性冠脉综合征患者中很常见，在有抑郁或焦虑症状的患者中更严重。通过心脏康复随访，认知障碍显着降低。一小部分患者有持续的、多领域的认知障碍，标志着潜在的长期变化，需要进一步调查和认知康复。