Pathophysiology of vascular cognitive disorders associated with myocardial infarction

According to the World Health Organization, there is an anticipated increase in the number of patients suffering from dementia by 2030. Unfortunately, the initial symptoms noticeable to patients and their surroundings tend to appear relatively late after the onset of the disease, which is a poor prognostic factor. There are numerous etiological factors contributing to the development of cognitive impairments. Vascular dementia accounts for the second most common type of dementia among disease cases and will be discussed in this article. It is important to note that lipid metabolism disorders affect approximately 58.4% of the Russian population, representing one of the main risk factors for myocardial infarction, which is directly associated with the development of vascular cognitive disorders (VCD). According to the studies referenced in this review, it was found that patients who have experienced a myocardial infarction show an increased risk of developing cognitive disorders related to pathological changes such as neuroinflammation and reduced density of dendritic cells. Additionally, it was determined that apoptosis and alterations in “Alzheimer’s-associated” proteins across different brain regions during myocardial conditions contribute to the development of vascular cognitive impairment. The pathophysiological link between myocardial infarction and VCD is mediated by vascular dysregulation, impaired cerebral perfusion, and factors such as oxidative stress, inflammation, neurovascular dysfunction, atherosclerosis, and reperfusion injury, leading to microinfarctions, hypoperfusion, and cognitive impairment. An increased risk of developing VCD is observed in patients following coronary revascularization, necessitating special attention to their cognitive status in the post-primary period.

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