Neuropsychological outcome after percutaneous coronary intervention or coronary artery bypass grafting: results from the Stent or Surgery (SoS) Trial.
BACKGROUND
Coronary artery bypass surgery (CABG) has been associated with a range of neurological and neuropsychological complications from stroke to cognitive problems such as memory and problem solving disturbance. However, little is known about the impact of percutaneous coronary intervention (PCI) on neuropsychological outcome.


RESULTS
In the Stent or Surgery Trial (SoS), 988 patients were randomized in equal proportions between PCI supported by stent implantation and CABG. As a substudy of this trial, we undertook an evaluation of neurological and neuropsychological outcomes after intervention. A clinical examination and neuropsychological assessment consisting of 5 tests (Digit Span Forwards and Backwards, Visual Reproduction, Bourdon, and Block Design) were performed at baseline and 6 and 12 months after the procedure. A total of 145 patients were included in the substudy analysis: 77 in the PCI group and 68 in the CABG group. One patient in the PCI arm had a stroke. There was no significant difference between treatment groups at 6 and 12 months for any of the 5 tests. The mean change from baseline was also similar in both groups.


CONCLUSIONS
We were not able to demonstrate an important and significant difference in neuropsychological outcome in patients treated with different revascularization strategies. This important finding needs to be examined in further research.
Währborg
Peter
P
Department of Cardiology, Sahlgrenska University Hospital, S-413 45 Gothenburg. Sweden. peter.wahrborg@hjl.gu.se
Booth
Jean E
JE
Clayton
Tim
T
Nugara
Fiona
F
Pepper
John
J
Weintraub
William S
WS
Sigwart
Ulrich
U
Stables
Rod H
RH
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D001026:Coronary Artery Bypass; D023903:Coronary Restenosis / Q000453:epidemiology / Q000601:surgery / Q000628:therapy; D023921:Coronary Stenosis / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012086:Reoperation; D015607:Stents; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*
D000319:Adrenergic beta-Antagonists