OBJECTIVE

To identify immunological predictors of development and unfavorable prognosis of postoperative cognitive dysfunction in patients with coronary artery disease after coronary artery bypass grafting (CABG).

MATERIAL AND METHODS

We examined 110 patients aged 59—74 years with coronary artery disease who underwent on-pump myocardial revascularization. Cognitive impairment was diagnosed using the Montreal Cognitive Examination Scale (MoCa test) before surgery and in 7 days after surgery. According to the MoCa test, 2 groups were distinguished. The first group consisted of 56 subjects with MoCa score decrease by less than 3 points after CABG, the second group included 54 subjects with reduction of this parameter by more than 3 points. The third group consisted of 25 people without severe diseases. Serum TNFα, IL10, S100 and NSE was analyzed using enzyme-linked immunosorbent assay. Data were presented in pg/ml and ng/ml. Blood sampling was carried out before surgery, in 24 hours and 7 days after surgery.

RESULTS

The 2^nd group was characterized by slower and longer postoperative pro-inflammatory response of TNFα and early hyperproduction of IL10, as well as higher levels of neuropeptides S100β and NSE.

CONCLUSION

Patients with postoperative cognitive dysfunction have cytokine dysfunction with significant early anti-inflammatory response that leads to damage to the blood-brain barrier and decrease of compensatory capabilities in response to neuroinflammation.