title: Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo.
abstract: BACKGROUND
  Coronary artery bypass grafting (CABG) can be associated with postoperative cognitive impairment and ischemic stroke. No effective treatment is currently available. The aim of this study was to evaluate the effectiveness of piracetam to treat the cognitive impairment after CABG in an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial.
  
  
  METHODS
  Patients undergoing CABG (n = 98) were randomized to placebo (n = 48) or piracetam (n = 50). Study drugs were administered intravenously (150 mg/kg daily; 300 mg/kg on the day of surgery) from the day before surgery to 6 days after surgery, then orally (12 g/day) up to 6 weeks after surgery. Cognitive function was assessed before surgery (baseline) and 6 weeks after surgery (outcome) by using a battery of 12 neuropsychologic tests. The Spielberger Anxiety Inventory and the Beck Depression Inventory were also administered. The combined score derived from the standardized neuropsychologic assessments was analyzed by using an analysis of covariance with baseline and education as covariates.
  
  
  RESULTS
  Six weeks after surgery, the combined score indicated a statistically significant treatment effect in the per protocol population (1.848, p = 0.041) and a tendency towards statistical significance in the intent-to-treat population (1.624, p = 0.064) in the group treated with piracetam, but no statistically significant treatment effect was seen in the placebo. The state of anxiety measured by the Spielberger Anxiety Inventory was decreased in both groups (-9.27 and -6.37 in the placebo and piracetam groups, respectively).
  
  
  CONCLUSIONS
  Six weeks after CABG, cognition was significantly improved in patients treated with piracetam. Additional trials are required to confirm these effects.
authors.affiliation: Department of Neurology, University of Targu-Mures, Targu Mures, Romania.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Szalma
authors.forename: Agnes
authors.initials: A
authors.lastname: Kiss
authors.forename: László
authors.initials: L
authors.lastname: Kardos
authors.forename: Géza
authors.initials: G
authors.lastname: Horváth
authors.forename: Erika
authors.initials: E
authors.lastname: Nyitrai
authors.forename: Zita
authors.initials: Z
authors.lastname: Tordai
authors.forename: László
authors.initials: L
authors.lastname: Csiba
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000008:administration & dosage*; D010889:Piracetam / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D018697:Nootropic Agents; D010889:Piracetam