BACKGROUND:Coronary artery bypass surgery (CABG) has been associated with a range of neurological and neuropsychological complications from stroke to cognitive problems such as memory and problem solving disturbance. However, little is known about the impact of percutaneous coronary intervention (PCI) on neuropsychological outcome. METHODS AND RESULTS: In the Stent or Surgery Trial (SoS), 988 patients were randomized in equal proportions between PCI supported by stent implantation and CABG. As a substudy of this trial, we undertook an evaluation of neurological and neuropsychological outcomes after intervention. A clinical examination and neuropsychological assessment consisting of 5 tests (Digit Span Forwards and Backwards, Visual Reproduction, Bourdon, and Block Design) were performed at baseline and 6 and 12 months after the procedure. A total of 145 patients were included in the substudy analysis: 77 in the PCI group and 68 in the CABG group. One patient in the PCI arm had a stroke. There was no significant difference between treatment groups at 6 and 12 months for any of the 5 tests. The mean change from baseline was also similar in both groups. CONCLUSIONS: We were not able to demonstrate an important and significant difference in neuropsychological outcome in patients treated with different revascularization strategies. This important finding needs to be examined in further research.
RCT Entities:
BACKGROUND: Coronary artery bypass surgery (CABG) has been associated with a range of neurological and neuropsychological complications from stroke to cognitive problems such as memory and problem solving disturbance. However, little is known about the impact of percutaneous coronary intervention (PCI) on neuropsychological outcome. METHODS AND RESULTS: In the Stent or Surgery Trial (SoS), 988 patients were randomized in equal proportions between PCI supported by stent implantation and CABG. As a substudy of this trial, we undertook an evaluation of neurological and neuropsychological outcomes after intervention. A clinical examination and neuropsychological assessment consisting of 5 tests (Digit Span Forwards and Backwards, Visual Reproduction, Bourdon, and Block Design) were performed at baseline and 6 and 12 months after the procedure. A total of 145 patients were included in the substudy analysis: 77 in the PCI group and 68 in the CABG group. One patient in the PCI arm had a stroke. There was no significant difference between treatment groups at 6 and 12 months for any of the 5 tests. The mean change from baseline was also similar in both groups. CONCLUSIONS: We were not able to demonstrate an important and significant difference in neuropsychological outcome in patients treated with different revascularization strategies. This important finding needs to be examined in further research.
Authors: Elizabeth L Whitlock; L Grisell Diaz-Ramirez; Alexander K Smith; W John Boscardin; Michael S Avidan; M Maria Glymour Journal: Ann Thorac Surg Date: 2018-12-18 Impact factor: 4.330
Authors: Charles W Hogue; Tamara Hershey; David Dixon; Robert Fucetola; Abdullah Nassief; Kenneth E Freedland; Betsy Thomas; Kenneth Schechtman Journal: Anesth Analg Date: 2006-06 Impact factor: 5.108
Authors: Fred H Edwards; David M Shahian; Maria V Grau-Sepulveda; Frederick L Grover; John E Mayer; Sean M O'Brien; Elizabeth DeLong; Eric D Peterson; Charles McKay; Richard E Shaw; Kirk N Garratt; George D Dangas; John Messenger; Lloyd W Klein; Jeffrey J Popma; William S Weintraub Journal: Ann Thorac Surg Date: 2014-04-26 Impact factor: 4.330
Authors: David L McDonagh; Miles Berger; Joseph P Mathew; Carmelo Graffagnino; Carmelo A Milano; Mark F Newman Journal: Lancet Neurol Date: 2014-04-02 Impact factor: 44.182
Authors: Pranav Kansara; Sandra Weiss; William S Weintraub; Matthew C Hann; James Tcheng; S Tanveer Rab; Lloyd W Klein Journal: JACC Cardiovasc Interv Date: 2015-11 Impact factor: 11.195
Authors: J L Rudolph; K A Schreiber; D J Culley; R E McGlinchey; G Crosby; S Levitsky; E R Marcantonio Journal: Acta Anaesthesiol Scand Date: 2010-04-15 Impact factor: 2.105