Cause of Cognitive Decline After Heart Bypass Examined

Coronary artery disease itself is more likely the cause of decline than use of pump

12 aug 2009 -- Use of a pump during coronary artery bypass surgery does not appear to be responsible for long-term loss of cognitive function and memory in patients with coronary artery disease; it instead may be due to the disease itself, according to a study in the August issue of the Annals of Thoracic Surgery.

Ola A. Selnes, Ph.D., and colleagues from Johns Hopkins University in Baltimore compared cognitive outcomes in 152 patients after on-pump coronary artery bypass surgery, 75 patients with off-pump bypass surgery, 99 non-surgical cardiac patients who received drugs and arterial stents, and 69 heart-healthy subjects.

After 72 months, the researchers found that there were no consistent differences in cognitive function among the patients with coronary artery disease. Although these patients had lower cognitive function at baseline and a greater degree of decline compared with heart-healthy subjects, the decline was small, and none were substantially worse off at 72 months.

"Long-term postoperative cognitive decline probably exists, but evidence is accumulating that advanced age and atherosclerosis may be more important determinants of long-term cognitive decline than a history of cardiac operations," Diederik van Dijk, M.D., from University Medical Center Utrecht in the Netherlands writes in an accompanying editorial.

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