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Ann Thorac Surg. 2013 Oct;96(4):1294-1300. doi: 10.1016/j.athoracsur.2013.05.001. Epub 2013 Jul 16.

Cognitive outcomes 7.5 years after angioplasty compared with off-pump coronary bypass surgery.

Author information

1
Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: a.c.sauer@umcutrecht.nl.
2
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
3
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
4
Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
5
Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
6
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Abstract

BACKGROUND:

Off-pump coronary artery bypass grafting and percutaneous coronary intervention are both associated with cognitive decline, but limited data are available on long-term outcomes. This study compared long-term cognitive outcomes between patients managed with percutaneous coronary intervention and off-pump coronary artery bypass grafting.

METHODS:

A multicenter trial in the Netherlands randomized 280 patients to percutaneous coronary intervention or off-pump coronary artery bypass grafting. Cognitive performance 7.5 years after randomization was assessed through a battery of 9 neuropsychologic tests and summarized into a combined Z-score.

RESULTS:

After 7.5 years, cognitive assessment could be performed in 81% of the 249 surviving patients. Better cognitive performance was observed in the off-pump coronary artery bypass grafting group (combined Z-score 0.11 for off-pump coronary artery bypass grafting versus -0.17 for percutaneous coronary intervention; difference 0.28, 95% confidence interval 0.08 to 0.47, p < 0.01). However, this difference became nonsignificant (Z-score difference 0.14, 95% confidence interval -0.01 to 0.29, p = 0.08) after multivariable adjustment for potential confounders.

CONCLUSIONS:

At 7.5 years follow-up, off-pump coronary artery bypass grafting patients had a similar or perhaps even better cognitive performance compared with percutaneous coronary intervention patients.

KEYWORDS:

23

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