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

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-...

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Published inThe 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
LanguageEnglish
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
Online AccessGet full text
ISSN0003-4975
1552-6259
1552-6259
DOI10.1016/j.athoracsur.2013.05.001

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Abstract 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.
AbstractList 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.BACKGROUNDOff-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.METHODSA 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.RESULTSAfter 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.CONCLUSIONSAt 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.
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.
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.
Author Kalkman, Cor J.
van Dijk, Diederik
Regieli, Jakub
Hendrikse, Jeroen
Veldhuijzen, Dieuwke S.
Doevendans, Pieter A.
Grobbee, Diederick E.
Sauër, Anne-Mette C.
Peelen, Linda M.
Nathoe, Hendrik M.
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Snippet Off-pump coronary artery bypass grafting and percutaneous coronary intervention are both associated with cognitive decline, but limited data are available on...
Background Off-pump coronary artery bypass grafting and percutaneous coronary intervention are both associated with cognitive decline, but limited data are...
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SubjectTerms 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
Title Cognitive Outcomes 7.5 Years After Angioplasty Compared With Off-Pump Coronary Bypass Surgery
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https://dx.doi.org/10.1016/j.athoracsur.2013.05.001
https://www.ncbi.nlm.nih.gov/pubmed/23866798
https://www.proquest.com/docview/1443385331
Volume 96
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