Cognitive Outcomes 7.5 Years After Angioplasty Compared With Off-Pump Coronary Bypass Surgery

• Published in: The Annals of thoracic surgery Vol. 96; no. 4; pp. 1294 - 1300
• Main Authors: Sauër, Anne-Mette C., Nathoe, Hendrik M., Hendrikse, Jeroen, Peelen, Linda M., Regieli, Jakub, Veldhuijzen, Dieuwke S., Kalkman, Cor J., Grobbee, Diederick E., Doevendans, Pieter A., van Dijk, Diederik
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.10.2013
• Subjects: Angioplasty; Cardiothoracic Surgery; Cognition; Confidence Intervals; Coronary Artery Bypass, Off-Pump; Female; Follow-Up Studies; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Surgery; Time Factors; Treatment Outcome; 23
• ISSN: 0003-4975; 1552-6259; 1552-6259
• DOI: 10.1016/j.athoracsur.2013.05.001

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. 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. 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. 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.