A new study challenges previous findings that patients undergoing elective coronary bypass grafting (CABG), or valve replacement, experience long-term cognitive decline. According to the study published in Neurology, the scientific journal of the American Academy of Neurology, that's not always the case.

The study compared the cognitive abilities of 52 patients prior to their CABG surgery and five years after. None of the patients showed clinically significant cognitive decline (defined as a decline of 1 standard deviation or more in at least two of the seven-part Wilcoxon tests administered). Other studies have reported late cognitive decline after CABG, however, none of these long-term follow-up studies included a control group like this one conducted at a hospital in Wurzburg, Germany. According to neurologist Wolfgang Mullges, MD, the study author, "No individual patient showed a global decline at follow-up as compared to baseline. Seven patients (13 percent) had worse results in one single test."

The researchers also compared follow-up data with data obtained at discharge. Even then, only four patients (8 percent) showed a standard deviation of more than 1 percent in two of the tests. Sixteen patients (31 percent) had lower follow-up test scores in only one of the tests, and 46 (88 percent) had better results in at least one test.

The patients in this study may have had better outcomes through general medical care and by reducing vascular risk factors following their CAGB, said Mullges. "Many of the individuals had stopped smoking, many were prescribed statins, and many took steps to control their diabetes and hypertension," said Mullges.

A shortcoming of the study was a lack of data or incomplete data from a portion of the 92 original members of the patient group which may have introduced a bias toward a better outcome.

Mullges said neurologists work with their patients to provide care that reduces vascular risk for myocardial infarction, stroke and vascular dementia and contributes to a better quality of life for the growing elderly population. "Treatment of cardiac patients means more than surgery," he said.

The American Academy of Neurology, an association of 18,000 neurologists and neuroscience professionals in 90 countries, is dedicated to improving patient care through education and research. For more information about the American Academy of Neurology, visit its web site at www.aan.com.

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CITATIONS

Neurology, Sep-2002 (Sep-2002)