title: Cognitive outcomes 7.5 years after angioplasty compared with off-pump coronary bypass surgery.
abstract: BACKGROUND
  Off-pump coronary artery bypass grafting and percutaneous coronary intervention are both associated with cognitive decline, but limited data are available on long-term outcomes. This study compared long-term cognitive outcomes between patients managed with percutaneous coronary intervention and off-pump coronary artery bypass grafting.
  
  
  METHODS
  A multicenter trial in the Netherlands randomized 280 patients to percutaneous coronary intervention or off-pump coronary artery bypass grafting. Cognitive performance 7.5 years after randomization was assessed through a battery of 9 neuropsychologic tests and summarized into a combined Z-score.
  
  
  RESULTS
  After 7.5 years, cognitive assessment could be performed in 81% of the 249 surviving patients. Better cognitive performance was observed in the off-pump coronary artery bypass grafting group (combined Z-score 0.11 for off-pump coronary artery bypass grafting versus -0.17 for percutaneous coronary intervention; difference 0.28, 95% confidence interval 0.08 to 0.47, p < 0.01). However, this difference became nonsignificant (Z-score difference 0.14, 95% confidence interval -0.01 to 0.29, p = 0.08) after multivariable adjustment for potential confounders.
  
  
  CONCLUSIONS
  At 7.5 years follow-up, off-pump coronary artery bypass grafting patients had a similar or perhaps even better cognitive performance compared with percutaneous coronary intervention patients.
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: a.c.sauer@umcutrecht.nl.
authors.forename: Anne-Mette C
authors.initials: AC
authors.lastname: Sauër
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: Nathoe
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hendrikse
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Peelen
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Jakub
authors.initials: J
authors.lastname: Regieli
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Dieuwke S
authors.initials: DS
authors.lastname: Veldhuijzen
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.affiliation: Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Diederik
authors.initials: D
authors.lastname: van Dijk
mesh_terms: D017130:Angioplasty; D003071:Cognition; D016001:Confidence Intervals; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D013997:Time Factors; D016896:Treatment Outcome
keywords: 23