Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures

Abstract

Cardiac surgical procedures assisted by cardiopulmonary bypass (CPB) impair cognitive functions. Several studies, however, showed that cognitive functions were unaffected in patients undergoing either primary coronary artery bypass grafting (CABG) or more complex surgery assisted by CPB. Therefore, we conducted a straightforward study to compare patient groups who differed significantly in terms of risk factors such as prolonged CPB times. Consecutive patients (n = 54) were included, undergoing either non-primary CABG, e.g. valve and/or CABG, (n = 30) or primary CABG (n = 24), assisted by CPB. Cognitive function was determined pre-operatively on the day of hospital admission, and post-operatively after one and six months using the Cognitive Drug Research computerized assessment battery. Data from the fourteen individual task variables were summarized in four composite scores: Power of Attention (PoA), Continuity of Attention (CoA), Quality of Episodic Memory (QoEM), and Speed of Memory (SoM). In the non-primary CABG patients, both CoA and QoEM improved after 1 month (p = 0.001 and p = 0.016, respectively), whereas, after 6 months, CoA (p = 0.002), QoEM (p = 0.002) and SoM (p < 0.001) were improved. In primary CABG patients, CoA improved at one month after surgery (p = 0.002) and, after six months, not only CoA (p = 0.003), but also QoEM and SoM were improved (p = 0.001 and p = 0.030, respectively). The test performance was similar in non-primary and primary CABG patients after surgery. Our present study shows a post-operative improvement of cognitive composite scores after cardiac surgery assisted by CPB in both non-primary CABG and in primary CABG patients.

Use of computerized tests to assess the cognitive impact of interventions in the elderly

“…Level of schooling and cognition were also expressed in different ways. A number of authors did not report the educational level of the population studied 9 , 16 , 18 , 24 , 32 , 33 , 37 while the majority expressed schooling as mean years of education 6 , 10 , 13 , 15 , 20 , 27 , 28 , 30 , 36 giving an overall mean of 11.5 years and range of 14.1-4.2 years, with the latter lower figure attributed to the study conducted in Brazil. Among the studies opting to express schooling by category, a wide variety of classifications was observed.…”

Coronary revascularization in patients with type 2 diabetes and results of the BARI 2D trial

“…The negative impact of diabetes on vein grafts may be circumvented in part by the use of arterial grafts whenever feasible. Morbidity associated with CABG can be considerable [106][107][108][109][110] and may include at least transitory postoperative cognitive impairment. Nevertheless, just as is the case with PCI, advances in surgical techniques have led to improvement in outcomes after CABG.…”

A perspective on the development of coronary revascularization

“…One is the possible impairment of cognitive function after CABG [62]. This issue is complex, however, in view of an improvement after an initial decline in cognitive function over time after CABG [62].…”

“…One is the possible impairment of cognitive function after CABG [62]. This issue is complex, however, in view of an improvement after an initial decline in cognitive function over time after CABG [62]. Furthermore, it is possible that the rate and magnitude of decline in cognition may not differ in patients with CAD who have not undergone CABG [63].…”