Prevalence, Incidence and Characterization of Neurocognitive Impairment in Acute Coronary Syndrome. A Systematic Review and Meta-Analysis

Background: Neuropsychological research in cardiovascular diseases has focused mainly in heart failure. The present systematic review aims to determine the incidence of neurocognitive dysfunction in acute coronary syndrome (ACS) and to define the neurocognitive functions most affected in ACS. Methods: The systematic review was performed in June 2016 on Pubmed. No restrictions were established regarding publication date, language, age of the participants in each study, nor type of study or experimental design. Results: Four studies were selected out of 74, once they address to at least one of the aims. The prevalence of neurocognitive dysfunction ranges between 10.51% and 66.8%. We could determinate the incidence rate in two studies, ranging from 0.0277 cases per year to 0.416 cases per month. Alterations in verbal memory, language and executive functioning were found. Conclusions: The variability of prevalence rates of neurocognitive dysfunction in ACS across studies may be due to the use of different neuropsychological instruments, different times of neuropsychological assessment and diverse demographical and clinical characteristics of the samples. In the future, further studies must clarify the neurocognitive tests that are more sensitive to ACS. The study of the interaction between risk factors, biomarkers, behavioral and environmental aspects as well as the clinical features of ACS and its treatment on brain and neurocognitive functioning, should also be clarifie