Prospective cohort study of longitudinal changes in cognitive function over 1 year in patients presenting with acute myocardial infarction

Abstract Background Cognitive impairment has been described as a consequence of acute myocardial infarction (AMI). While much of the focus has been on memory deficits following AMI, the full spectrum of cognitive changes remains underexplored. Purpose This study aimed to assess the longitudinal change in cognitive function in a patients presenting with AMI over a 1-year period. Methods A prospective cohort of AMI patients was enrolled. Baseline clinical and demographic data were collected at admission. Cognitive function was assessed longitudinally using the more comprehensive neuropsychological battery, including the Rey Auditory Verbal Learning Test (RAVLT) for memory, the Colour Trails Test for executive function, the Digit Span test for attention, the Boston Naming Test for language, and the Block Design Test for visuospatial ability. These tests were performed within two weeks of index admission for AMI, and at 1 year post admission. Paired T-test comparisons were used to assess changes in cognitive performance over the 1-year period. Results A total of 104 patients were enrolled with a mean age 54.5 (11) years and predominantly male (93%). (Table 1). Over a one-year follow up (Table 2), significant declines were observed in memory performance, with the RAVLT showing a mean reduction in delayed recall of −0.974 (p = 0.035), and the Brief Visuospatial Memory Test-Revised (BVMT-R) exhibiting an -8.43 mean decrease in retention (p = 0.026). In terms of executive function, the Color Trails Test showed improved speed with a reduction in completion time (mean difference −5.166, p = 0.01), but at the expense of increased errors (mean difference +1.263, p 0.001) and lifts (mean difference +0.474, p = 0.001). Stroop Test revealed faster word reading (mean difference −1.801, p 0.001), indicating preserved processing speed and fluency. No significant changes were observed in attention or language functions, with the Digit Span and Boston Naming Test revealing no significant changes over the 1-year period. Visuospatial ability, as measured by the Block Design test, remained stable with no significant changes. Conclusion This study demonstrated significant declines in memory performance, particularly in delayed recall, and may also suggest mild decline in executive function decline following AMI. No significant changes were observed in attention, language, or visuospatial ability, underscoring the uneven deterioration of cognitive domains following AMI. These findings highlight the need for targeted rehabilitation strategies and further research into the mechanisms underlying cognitive decline after AMI.