title: Asymptomatic carotid artery stenosis and cognitive outcomes after coronary artery bypass grafting.
abstract: OBJECTIVE
  Cognitive decline has a negative impact on early postoperative morbidity and affects subjective quality of life. The role of asymptomatic cerebrovascular disease in developing postoperative neurocognitive damage remains controversial. The aim of our study was to evaluate the impact of asymptomatic carotid artery stenosis on postoperative cognitive decline.
  
  
  METHODS
  We investigated 127 patients undergoing coronary artery bypass grafting. The neuropsychological examination, including a cognitive battery of seven tests and two scales for evaluation of mood disorders, was conducted the day before surgery and before the discharge from hospital.
  
  
  RESULTS
  Early postoperative cognitive decline (POCD) was detected in 46% of patients. POCD was associated with longer duration of surgery (p = 0.02), low cardiac output syndrome perioperatively (p < 0.05), postoperative bleeding (p = 0.03), longer postoperative mechanical ventilation time and intensive care unit stay (p < 0.05). Carotid artery lesion was detected in 42 (68.8%) patients. Multivariate regression analysis showed that carotid artery stenosis of more than 50% was an independant predictor of POCD (OR 26.89, CI 6.44-112.34).
  
  
  CONCLUSIONS
  Asymptomatic carotid artery stenosis is a risk factor for cognitive decline after coronary artery bypass grafting.
authors.affiliation: Clinic of Anesthesiology and Intensive Care, Faculty of Medicine, Vilnius University, Lithuania. ievanork@gmail.com
authors.forename: Ieva
authors.initials: I
authors.lastname: Norkienė
authors.forename: Robertas
authors.initials: R
authors.lastname: Samalavičius
authors.forename: Juozas
authors.initials: J
authors.lastname: Ivaškevičius
authors.forename: Valmantas
authors.initials: V
authors.lastname: Budrys
authors.forename: Kotryna
authors.initials: K
authors.lastname: Paulauskiene
mesh_terms: D000368:Aged; D002303:Cardiac Output, Low / Q000150:complications; D016893:Carotid Stenosis / Q000601:surgery*; D003072:Cognition Disorders / Q000453:epidemiology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000150:complications; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome