Cognitive decline after off-pump versus on-pump coronary artery bypass graft surgery: Meta-analysis of randomized controlled trials

Takagi, Hisato; Tanabashi, Toshiyuki; Kawai, Norikazu; Umemoto, Takuya

doi:10.1016/j.jtcvs.2007.04.035

Cited by 25 publications

(7 citation statements)

References 13 publications

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“…Interestingly they did not include two RCTs we have included in this manuscript with unpublished data from the authors [44]. Two papers they did include however, we chose to exclude due to failure to conform to the consensus statement of cognitive testing after CABG [10] and reporting of cognitive outcomes as the number of deteriorations per group (susceptible to regression toward the mean) without reporting group means [11].…”

Section: Discussionmentioning

confidence: 99%

No improvement in neurocognitive outcomes after off-pump versus on-pump coronary revascularisation: a meta-analysis

Marasco

Sharwood

Abramson

2008

European Journal of Cardio-Thoracic Surgery

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The popularity of off-pump (beating heart) coronary artery bypass grafting (CABG) was initially stimulated by numerous theoretical benefits including lower incidence of stroke and neurocognitive dysfunction. With a postoperative stroke rate of less than 1% for elective CABG, it has been very difficult to demonstrate any significant differences in this outcome between techniques. However, changes in neurocognitive function are more common in the postoperative setting and thus provide greater power for demonstrating improvement with changes in surgical technique. The aim of this meta-analysis was to assess whether there were significant differences in neurocognitive outcomes in patients after undergoing off-pump versus on-pump CABG. A database search for prospective randomised controlled trials of off-pump versus on-pump CABG in any language was conducted. Eight trials incorporating 892 patients fulfilled all the inclusion criteria for reporting of neurocognitive outcomes, and were able to be included in this meta-analysis. Sufficient data were available across the seven studies to combine results for five neurocognitive tests (Rey Auditory Verbal Learning, Grooved Pegboard, Trail A and B, and Digit Symbol). Overall there were no convincing differences in outcomes in neurocognitive testing between off-pump and on-pump CABG groups. The results of this meta-analysis show that there are no significant neurocognitive benefits when comparing off-pump versus on-pump CABG.

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Section: Discussionmentioning

confidence: 99%

No improvement in neurocognitive outcomes after off-pump versus on-pump coronary revascularisation: a meta-analysis

Marasco

Sharwood

Abramson

2008

European Journal of Cardio-Thoracic Surgery

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“…Although some early observational studies reported lower incidence of cognitive decline after OPCAB, more recent randomized controlled trials have not found significant differences between on- and off-pump surgeries in the degree of early or late cognitive outcomes. 3-5 These findings indicate that long-term cognitive changes may not be specific to a CABG population.…”

Section: Introductionmentioning

confidence: 92%

Do Management Strategies for Coronary Artery Disease Influence 6-Year Cognitive Outcomes?

Selnes

Grega

Bailey

et al. 2009

The Annals of Thoracic Surgery

118

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“…Studies have demonstrated that OPCAB is associated with significant reduction in neurocognitive decline, although the data were inconclusive. 30,31 A study by Takagi et al 32 demonstrated improved cognitive outcomes at 1 and 3 months after OPCAB and negligible effects at 6 and 12 months, but the lack of sensitivity analysis in that study limited its validity.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Dysfunction after Off-Pump versus On-Pump Coronary Artery Bypass Surgery: A Meta-Analysis

Wang

et al. 2012

J Int Med Res

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Cognitive decline after off-pump versus on-pump coronary artery bypass graft surgery: Meta-analysis of randomized controlled trials

Cited by 25 publications

References 13 publications

No improvement in neurocognitive outcomes after off-pump versus on-pump coronary revascularisation: a meta-analysis

No improvement in neurocognitive outcomes after off-pump versus on-pump coronary revascularisation: a meta-analysis

Do Management Strategies for Coronary Artery Disease Influence 6-Year Cognitive Outcomes?

Cognitive Dysfunction after Off-Pump versus On-Pump Coronary Artery Bypass Surgery: A Meta-Analysis

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