Long-term cognitive decline in bypass patients not due ...( Among the many factors involved in d...),Health

Among the many factors involved in deciding how to treat coronary artery disease, physicians must evaluate overall outcomes and the potential for complications. Some studies have found that cognitive decline and neurologic complications, such as stroke, have been associated with coronary artery bypass surgery. A new study finds no evidence that bypass patients have a greater risk of long-term cognitive decline than patients not undergoing surgery. The study is published in the May 2008 issue of Annals of Neurology (http://www.interscience.wiley.com/), the official journal of the American Neurological Association.

Led by Ola A. Selnes and Guy M. McKhann of the Johns Hopkins University School of Medicine, the study involved 152 patients who had bypass surgery and 92 patients with coronary artery disease who did not have surgical intervention. Patients underwent a series of memory and other cognitive tests at the beginning of the study period, and after 3, 12, 36 and 72 months. Of these, 96 bypass patients and 61 control patients completed cognitive testing after six years.

The results showed that there were no significant differences in cognitive scores between the two groups at the beginning of the study. Both groups showed modest decline in cognitive performance during the study period, but there were no significant differences in the degree of decline between the groups after six years.

The authors point out that the bypass patients had conditions that might be associated with worse cognitive performance, including higher incidence of cardiovascular risk factors, more severe coronary artery disease and more surgery requiring general anesthesia during the follow-up period. Despite these factors, no differences between the two groups were found. While other studies have looked at the long-term effects of bypass surgery on cognitive function, this is the first prospective long-term stu
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