{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:46:05Z","timestamp":1785422765983,"version":"3.56.0"},"reference-count":49,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Timi\u0219oara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: A relationship between cognitive decline (CD) and chronic coronary syndrome (CCS), common among the elderly population, has not yet been clearly established. Our study aims to evaluate the link between severe cognitive impairment and cognitive impairment, as measured by various neuropsychological tests in patients with or without CCS. In addition, we sought to identify cardiovascular risk factors (CVRFs) that influence the severity of CD and severe cognitive impairment. Materials and Methods: This observational study was conducted on 264 people with CVRFs. Of the 264, 132 were classified as patients with CCS and 132 as control subjects without CCS. Neuropsychological assessment tools included the Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) scales, the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale (GDS-15). Clinical characteristics, echocardiographic measures, and vascular parameters of all subjects were also evaluated. Results: Patients with CCS had significantly lower cognitive performance (MMSE, p = 0.010; MoCA, p = 0.021), reduced functional status (IADL, p = 0.030; ADL, p = 0.012), and higher depression scores (p = 0.004) compared with controls. They also had worse cardiovascular profiles, including lower left ventricular ejection fraction (LVEF) (p = 0.001), higher NT-proBNP levels (p = 0.005), and increased carotid intima-media thickness (IMT) (p &lt; 0.05). IMT and blood pressure values were negatively correlated with cognitive and functional scores and positively correlated with depression severity (p &lt; 0.001). Multivariate analysis identified systolic and diastolic blood pressure, age, body mass index, heart rate, reduced daily activity, and depression as independent predictors of cognitive decline in patients with CCS. In the GDS-15 score, each unit increase was associated with a 32.1% higher risk of cognitive decline and a 37.1% higher risk of MMSE-defined severe cognitive impairment, while improved ADL scores significantly reduced this risk. Conclusions: CCS is associated with an increased risk of severe cognitive impairment and also with cognitive decline, influenced by hypertension, subclinical atherosclerosis, depression, and reduced functional status. These findings emphasize the importance of early identification and multidisciplinary management of cognitive impairment in patients with CCS to prevent progression to severe cognitive impairment.<\/jats:p>","DOI":"10.3390\/medicina62071239","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:54:42Z","timestamp":1782694482000},"page":"1239","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive Decline in Chronic Coronary Syndrome: Associations with Vascular, Cardiac, and Neuropsychological Parameters"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3464-5782","authenticated-orcid":false,"given":"Marius","family":"Militaru","sequence":"first","affiliation":[{"name":"Department of Neuroscience, University Clinic of Neurology II, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Emergency City Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Centre of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Florin","family":"Lighezan","sequence":"additional","affiliation":[{"name":"Emergency City Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Centre of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Department of Internal Medicine I, University Clinic of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-9561","authenticated-orcid":false,"given":"Florina","family":"Buleu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3536-6099","authenticated-orcid":false,"given":"Stela","family":"Iurciuc","sequence":"additional","affiliation":[{"name":"Emergency City Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Department of Cardiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1728-3552","authenticated-orcid":false,"given":"Daian-Ionel","family":"Popa","sequence":"additional","affiliation":[{"name":"Emergency City Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Research Center for Medical Communication, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5455-5341","authenticated-orcid":false,"given":"Anda Gabriela","family":"Militaru","sequence":"additional","affiliation":[{"name":"Emergency City Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania"},{"name":"Centre of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Department of Internal Medicine I, University Clinic of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC Guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur. 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