Presence of coronary collaterals is associated with a decreased incidence of cognitive decline after coronary artery bypass surgery☆

Abstract

In patients undergoing first-time coronary artery bypass grafting, presence of coronary collaterals is associated with a decreased risk of cognitive decline at both 3 and 12 months of follow-up. This trend persists at 5-year follow-up. Preoperative differences in the cardiac vascular condition may therefore predict cognitive outcome in patients undergoing coronary artery bypass grafting.

Diabetes is associated with risk of postoperative cognitive dysfunction: A meta‐analysis

“…Of the 14 studies, 13 had prospective observational designs; 1 randomized controlled trial compared cognitive outcomes between on‐pump and off‐pump coronary artery bypass grafting and analyzed their data with adjustment for surgery type . A single investigation was on glycemic control in a sample of 124 patients with diabetes; all other studies investigated POCD according to diabetes status and enrolled a total of N = 2990 patients of which N = 2518 were retained for follow‐up (see Table ). Publication dates spanned 2001 to 2015, and studies stemmed from countries in Europe, Asia, North America, and Australia.…”

Does rich coronary collateral circulation distal to chronically occluded left anterior descending artery compete with graft flow?

“…Well-developed collaterals can supply sufficient perfusion without leading to any symptoms, although lack of collaterals can cause fatal ischaemia and subsequent infarction. Previous reports demonstrated that the degree of coronary collateral perfusion itself could influence clinical outcomes in patients with coronary artery stenosis [13,14]. Therefore, the degree of coronary collateral development should be precisely evaluated to establish optimal treatment strategies.…”

“…Therefore, the degree of coronary collateral development should be precisely evaluated to establish optimal treatment strategies. The Rentrop grade is a well-established means of scoring the degree of development of coronary collaterals according to the extent of contrast medium in the territory distal to CTO and has recently been applied in various studies [2,[13][14][15][16].…”

Predictors of cognitive dysfunction after cardiac surgery: a systematic review

“…Advancing age and education level appear to be the most important predictors identified, as older patients and those with lower educational levels can be prioritized when developing and trialling interventions to improve cognitive function. While advancing age has emerged as the most common predictor of cognitive outcome, 25,28,30,33,36,[40][41][42][43]46,48,50,54,56,57 this was reported inconsistently. Those that found age to be non-predictive of cognitive outcome tended to have smaller sample sizes.…”