title: Cognitive outcomes five years after not undergoing coronary artery bypass graft surgery.
abstract: BACKGROUND
  Patients with coronary artery disease who underwent coronary artery bypass graft surgery have a high risk of cognitive decline 5 years after the procedure. It is conceivable that this is not caused by the operation, but by natural aging.
  
  
  METHODS
  Psychologists repeatedly administered a battery of seven neuropsychological tests with eight main variables to 112 subjects without known coronary artery disease, with a time interval of 5 years. Cognitive decline was defined as deterioration in performance beyond normal variation in at least two of the eight main variables. The incidence of cognitive decline in the control subjects was compared with the incidence of cognitive decline in the 281 participants of the Octopus Study, who underwent coronary artery bypass graft surgery 5 years earlier. Patients and control subjects were age-matched.
  
  
  RESULTS
  After 5 years, cognitive outcome could be determined in 99 of 112 control subjects (88%) and 240 of 281 coronary artery bypass graft surgery patients (85%). Cognitive decline was present in 82 (34.2%) of 240 coronary artery bypass graft surgery patients and in 16 (16.2%) of 99 control subjects (crude odds ratio, 2.69; 95% confidence interval, 1.48 to 4.90). However, after correction for differences in age, sex, education, and baseline comorbidity between the patients and the control subjects, the odds ratio was 1.37 (95% confidence interval, 0.65 to 2.92).
  
  
  CONCLUSIONS
  We were unable to demonstrate that patients who underwent coronary artery bypass graft surgery have more cognitive decline after 5 years than control subjects without coronary artery disease.
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands. d.vandijk@umcutrecht.nl
authors.forename: Diederik
authors.initials: D
authors.lastname: van Dijk
authors.forename: Karel G M
authors.initials: KG
authors.lastname: Moons
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: Nathoe
authors.forename: Egidius H L
authors.initials: EH
authors.lastname: van Aarnhem
authors.forename: Cornelius
authors.initials: C
authors.lastname: Borst
authors.forename: Annemieke M A
authors.initials: AM
authors.lastname: Keizer
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
authors.forename: Ron
authors.initials: R
authors.lastname: Hijman
mesh_terms: D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors