Cognitive outcomes in elderly high-risk patients after off-pump versus conventional coronary artery bypass grafting: a randomized trial - PubMed (original) (raw)
Randomized Controlled Trial
. 2006 Jun 20;113(24):2790-5.
doi: 10.1161/CIRCULATIONAHA.105.587931. Epub 2006 Jun 12.
Affiliations
- PMID: 16769915
- DOI: 10.1161/CIRCULATIONAHA.105.587931
Randomized Controlled Trial
Cognitive outcomes in elderly high-risk patients after off-pump versus conventional coronary artery bypass grafting: a randomized trial
Birte Ostergaard Jensen et al. Circulation. 2006.
Abstract
Background: It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). However, evidence for this statement is preliminary, and additional insight is needed.
Methods and results: The study was a substudy of the randomized Best Bypass Surgery trial that compared OPCAB with CCAB treatment with respect to intraoperative and postoperative mortality and morbidity in patients with a moderate to high level of predicted preoperative risk. The outcome was cognitive function. A total of 120 elderly patients (mean age 76 years, SD 4.5 years) underwent psychometric testing before surgery and at a mean of 103 (SD 15) days postoperatively with a neuropsychological test battery that included 7 parameters from 4 tests. Cognitive dysfunction was defined as the occurrence of at least 2 of the 7 possible deficits. Secondary analysis was performed on the basis of the definition of a 20% decline in cognitive scores compared with baseline, and with z score analysis. Cognitive dysfunction was identified in 4 of the 54 patients (7.4%, 95% confidence interval [CI] 2.1% to 17.9%) in the OPCAB group and 5 of the 51 patients (9.8%, 95% CI 3.3% to 21.4%) in the CCAB group. We found no difference in incidence of cognitive dysfunction between the groups regardless of the definition applied.
Conclusions: In elderly high-risk patients, no significant difference was found in the incidence of cognitive dysfunction 3 months after either OPCAB or CCAB.
Republished in
Comment in
- Can cognition survive heart surgery?
Samuels MA. Samuels MA. Circulation. 2006 Jun 20;113(24):2784-6. doi: 10.1161/CIRCULATIONAHA.106.632711. Circulation. 2006. PMID: 16785349 No abstract available.
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