# Thiamine Intervention and Cognition in Older Adults Undergoing Coronary Artery Bypass Grafting- A Randomized Clinical Trial

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2023 · $432,057

## Abstract

PROJECT SUMMARY/ABSTRACT
 Coronary heart disease (CHD) is a common health issue, requiring over 230,500 patients to undergo
coronary artery bypass grafting (CABG) each year in the USA. Despite the fundamental goal of improving
function and increasing both duration and quality of life, CABG surgery is associated with increased risk of
deleterious cognition changes, which may contribute to early dementia and Alzheimer’s disease risks, increased
morbidity, mortality, and decreased quality of life and social function. However, the potential mechanisms
contributing to such deficits remain unclear, but may include stress-induced inflammatory storm and anaerobic
activities. High lactate levels, indicator of anaerobic metabolism, are common after CABG, and anaerobic
processes may contribute to post-CABG cognitive deficits. Anaerobic metabolic activities can be reduced with
infusion of thiamine, which is an essential co-factor in aerobic metabolism. In the absence of adequate thiamine
levels, pyruvate fails to enter the Krebs cycle, promoting anaerobic metabolism and increasing lactate
production. However, it is unclear whether a low-cost thiamine intervention can be used to reduce post-CABG
anaerobic activities and reduce cognitive issues in CHD subjects. Using a two-group, double-blind randomized,
longitudinal study design, 52 CHD patients undergoing CABG (age, 60-80 years; 26 thiamine treatment and 26
placebo) will participate for cognitive assessment and evaluation of blood thiamine, lactate, and inflammatory
marker levels. The specific aims are to: 1) assess thiamine treatment effect on blood lactate, thiamine, and
inflammatory (IL-10, IL-6, IL-1β, TNF-α) levels in older CHD subjects with and without intervention at baseline
(within 5 days) and one month after CABG; 2) examine the effect of thiamine intervention on cognition, evaluated
by the NIH Toolbox Cognition Battery, the Montreal Cognitive Assessment, and the Wide Range Assessment of
Memory and Learning 2, and relationships between lactate levels and cognition in CHD adults with and without
treatment at baseline (within 5 days) and one month after CABG; and 3) examine the effect of thiamine infusion
after CABG on long-term cognition, quality of life, and daily activities status at 6 mo after CABG in older CHD
subjects with and without treatment. In summary, post-CABG cognitive deficits are common in CHD patients.
Anaerobic metabolic activities that occur during perioperative period, are deleterious introducing cognitive
deficits and leading to dementia and Alzheimer’s disease risks that can be reduced with thiamine infusion.
Thiamine infusion will promote aerobic metabolism and reduce lactate and inflammatory levels, and will serve
as an intracellular proteolysis and breakdown protector. The findings have the potential to dramatically impact
clinical practice by offering evidence for a low-cost thiamine intervention that could be implemented on a large-
scale clinical trial to reduce post-CABG ...

## Key facts

- **NIH application ID:** 10811014
- **Project number:** 1R21AG081720-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Rajesh Kumar
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $432,057
- **Award type:** 1
- **Project period:** 2023-09-30 → 2026-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10811014

## Citation

> US National Institutes of Health, RePORTER application 10811014, Thiamine Intervention and Cognition in Older Adults Undergoing Coronary Artery Bypass Grafting- A Randomized Clinical Trial (1R21AG081720-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10811014. Licensed CC0.

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