Pharmacopsychiatry 2025; 58(03): 148
DOI: 10.1055/s-0045-1807311
Abstracts | AGNP/DGBP
Poster

Predicting one-year postoperative cognitive dysfunction after cardiac surgery by combining markers of amyloid-β and tau pathology

T Titsch
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
I Günther
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
K Packroß
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
M M Becker
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
A I Rediske
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
I Krasiuk
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
C Derad
2   Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
,
T Asendorf
2   Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
,
H Esselmann
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
C M Celano
3   Department of Psychiatry, Massachusetts General Hospital, Boston, United States
4   Department of Psychiatry, Harvard Medical School, Boston, United States
,
M Chebbok
5   Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
6   Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany
,
S Heinemann
5   Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
,
I Kutschka
7   Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center Göttingen, Göttingen, Germany
8   DZHK (German Center for Cardiovascular Research), partner site Göttingen, Germany
,
M Sadlonova
3   Department of Psychiatry, Massachusetts General Hospital, Boston, United States
5   Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
7   Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center Göttingen, Göttingen, Germany
8   DZHK (German Center for Cardiovascular Research), partner site Göttingen, Germany
9   Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
,
H Baraki
7   Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center Göttingen, Göttingen, Germany
8   DZHK (German Center for Cardiovascular Research), partner site Göttingen, Germany
,
CA F von Arnim
5   Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
8   DZHK (German Center for Cardiovascular Research), partner site Göttingen, Germany
,
J Wiltfang
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
10   German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
11   Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
12   equal contribution
,
N Hansen
1   Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
12   equal contribution
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Background: Delayed postoperative cognitive dysfunction (POCD) is a common phenomenon after cardiac surgery. As there is some evidence from blood-based studies that Alzheimer's disease (AD) pathology contributes to POCD, we investigated whether blood-based AD biomarkers can predict POCD in cardiac surgery patients.

Methods: In the “Find Delirium Risk Factors” (FINDERI) cohort, we analyzed preoperative EDTA-plasma samples from 382 patients. Cognitive function was assessed one year post-surgery using the Montreal Cognitive Assessment (MoCA) either via telephone or on-site. POCD was defined as a MoCA score decline from ≥ 21/30 at baseline to < 21/30 after 12 months or a persistent score < 21/30 with further decline. AD biomarkers were measured using Lumipulse (Aβ42, Aβ40, p-tau181) or Meso Scale Discovery immunoassays (p-tau 217). AUC and optimal cut-offs using simultaneous maximization of sensitivity and specificity were calculated for all biomarkers. Univariate and multivariable logistic regression with standardized biomarkers was used to identify the biomarkers potentially associated with POCD.

Results: POCD occurred in 30 of 394 (7.5%) patients. The Aβ42/40 ratio, p-tau217, the AT181 term (Aβ40/Aβ42*p-tau181) and the AT217term (Aβ40/ Aβ42*p-tau217) showed significant ability to discriminate POCD from non-POCD. P-tau217 and AT217 term predict POCD with moderate accuracy (p-tau217: AUC = 0.69 [95%-CI: 0.58, 0.78, p<0.001], cut-off: <3.64 [sensitivity: 0.62, specificity: 0.62, PPV: 0.12, NPV = 0.95]; AT217 term: AUC 0.692 [95%-CI: 0.59, 0.78, p<0.001], cut-off: <43.13 [sensitivity: 0.62, specificity: 0.59, PPV: 0.11, NPV = 0.95]. Multivariable logistic regressions confirmed p-tau217 (OR=2.00, 95%-CI: 1.11, 3.84, p<0.05) and the AT217 term (OR=1.6, 95%-CI: 1.04, 2.35, p<0.05) as independent predictors.

Conclusions: Our findings provide preliminary evidence that AD pathology, indicated by blood biomarkers, predicts POCD with moderate accuracy. p-tau217 and the AT217 term are key candidates for POCD risk assessment, supporting the potential of preoperative biomarker screening to identify at-risk patients.



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Artikel online veröffentlicht:
30. April 2025

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