Association of coronary artery bypass with cognitive impairment in coronary artery disease across APO (ε) genotypes in AllofUS

BACKGROUND: Coronary artery bypass graft (CABG) is a widely performed procedure for coronary artery disease (CAD), yet its association with Impaired Cognition (IC), i.e., mild-cognitive impairment or all-cause dementia, while accounting for APO (ε) genotype, remains unclear. METHODS: We analyzed AllofUS participants with CAD (Age≥60 yrs) from 2017-2023. We defined CAD as a history of angina/myocardial infarction/chronic ischemic heart disease or having percutaneous coronary intervention/CABG, and IC as mild cognitive impairment or all-cause dementia using ICD/SNOMED codes. We performed logistic regression analyses to assess the association between CABG and IC, adjusting for clinical factors (age, sex, hypertension, diabetes, hyperlipidemia, depression, stroke, smoking, alcohol use, statin/antihypertensive/antidiabetic use), social determinants (self-reported race/ethnicity, income, employment), and APO (ε) genotypes. We further performed stratified analyses across APO (ε) genotypes (ε2/ε2, ε2/ε3 ε3/ε3, ε2/ε4, ε3/ε4, ε4/ε4). We defined significance at p ≤ 0.05. RESULTS: ). CONCLUSION: In the AllofUS cohort, we observed an association between CABG and IC in CAD participants, with the strongest association in the APO ε2/ε3 group.