Luis M Pérez-Belmonte1, Carlos M San Román-Terán2, Manuel Jiménez-Navarro3, Miguel A Barbancho4, José M García-Alberca5, José P Lara4. 1. CMU (Clinical Management Unit) of Heart Department, Virgen de la Victoria University Hospital, Málaga, Spain; Unit of Cognitive Neurophysiology, Research Medical Center of Málaga University, ICE (International Campus of Excellence) Andalucía Tech, BRIM (Biomedical Research Institute of Málaga), Málaga, Spain. Electronic address: luismiguelpb@hotmail.com. 2. Department of Internal Medicine, Axarquía County Hospital, Vélez-Málaga, Málaga, Spain. 3. CMU (Clinical Management Unit) of Heart Department, Virgen de la Victoria University Hospital, Málaga, Spain. 4. Unit of Cognitive Neurophysiology, Research Medical Center of Málaga University, ICE (International Campus of Excellence) Andalucía Tech, BRIM (Biomedical Research Institute of Málaga), Málaga, Spain. 5. Department of Psychiatry, Unit of Dementia, Andalusia Institute of Neuroscience and Conduct, Málaga, Spain.
Abstract
OBJECTIVES: To assess cognitive impairment after off-pump coronary-artery bypass grafting, with a particular emphasis on long-term follow-up and related risk factors. DESIGN: Prospective study. SETTING: Virgen de la Victoria University Hospital, Málaga, Spain. PARTICIPANTS: Participants were 36 patients undergoing off-pump coronary-artery bypass grafting. MEASUREMENTS: Changes in the neuropsychological test battery administered from before to after surgery (1, 6, and 12 months). Postoperative cognitive impairment was defined by a significant decrease. RESULTS: A significantly multidomain (attention-executive functions, P < .01; immediate and delayed memory, P < .001; and verbal fluency, P < .05) postoperative cognitive impairment was shown, being maximum at 6 months (more than 50% of patients) and still presented at 12 months (more than 30% of patients), but partially recovered. Related risk factors as smoking (P < .01), diabetes mellitus (P < .01), peripheral arteriopathy (P < .01), obesity (P < .05), lower hematocrit (P < .01), and hemoglobin (P < .05) levels and diastolic blood pressure (P < .05) were identified as predictors of cognitive impairment. Better New York Heart Association class (P < .01) and less severity of angina (P < .01) were associated with partial postoperative recovering. CONCLUSION: A multidomain long-term postoperative cognitive impairment and a partial neurocognitive recovering were detected after off-pump coronary-artery bypass grafting and were associated with several nonspecific surgery factors. These findings may be useful when counseling patients before surgery and suggest the importance of long-term neurocognitive evaluation.
OBJECTIVES: To assess cognitive impairment after off-pump coronary-artery bypass grafting, with a particular emphasis on long-term follow-up and related risk factors. DESIGN: Prospective study. SETTING: Virgen de la Victoria University Hospital, Málaga, Spain. PARTICIPANTS: Participants were 36 patients undergoing off-pump coronary-artery bypass grafting. MEASUREMENTS: Changes in the neuropsychological test battery administered from before to after surgery (1, 6, and 12 months). Postoperative cognitive impairment was defined by a significant decrease. RESULTS: A significantly multidomain (attention-executive functions, P < .01; immediate and delayed memory, P < .001; and verbal fluency, P < .05) postoperative cognitive impairment was shown, being maximum at 6 months (more than 50% of patients) and still presented at 12 months (more than 30% of patients), but partially recovered. Related risk factors as smoking (P < .01), diabetes mellitus (P < .01), peripheral arteriopathy (P < .01), obesity (P < .05), lower hematocrit (P < .01), and hemoglobin (P < .05) levels and diastolic blood pressure (P < .05) were identified as predictors of cognitive impairment. Better New York Heart Association class (P < .01) and less severity of angina (P < .01) were associated with partial postoperative recovering. CONCLUSION: A multidomain long-term postoperative cognitive impairment and a partial neurocognitive recovering were detected after off-pump coronary-artery bypass grafting and were associated with several nonspecific surgery factors. These findings may be useful when counseling patients before surgery and suggest the importance of long-term neurocognitive evaluation.
Authors: Joanna S Semrau; Stephen H Scott; Andrew G Hamilton; Dimitri Petsikas; Darrin M Payne; Gianluigi Bisleri; Tarit Saha; John Gordon Boyd Journal: BMJ Open Date: 2019-12-03 Impact factor: 2.692