title: Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery.
abstract: BACKGROUND
  Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass.
  
  
  METHODS
  Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis.
  
  
  RESULTS
  A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; p<0.0005 and piracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; p<0.0005). However, the piracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (p<0.0005).
  
  
  CONCLUSIONS
  Piracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.
authors.affiliation: Department of Cardiovascular Surgery, Charite Hospital, Medical University, Berlin, Germany. sebastian.holinski@charite.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Holinski
authors.forename: Benjamin
authors.initials: B
authors.lastname: Claus
authors.forename: Nour
authors.initials: N
authors.lastname: Alaaraj
authors.forename: Pascal Maria
authors.initials: PM
authors.lastname: Dohmen
authors.forename: Kremena
authors.initials: K
authors.lastname: Kirilova
authors.forename: Konrad
authors.initials: K
authors.lastname: Neumann
authors.forename: Ralf
authors.initials: R
authors.lastname: Uebelhack
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
mesh_terms: D001927:Brain Diseases / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010889:Piracetam / Q000494:pharmacology*
chemical_list: D010889:Piracetam