Cognitive outcome after on- and off-pump coronary artery bypass grafting surgery: a systematic review and meta-analysis

J Cardiothorac Vasc Anesth. 2013 Apr;27(2):253-65. doi: 10.1053/j.jvca.2012.11.008.

Abstract

Objective: The aim of this study was to compare cognition following coronary artery bypass grafting (CABG) surgery with or without cardiopulmonary bypass (CPB) (on- or off-pump).

Design: Systematic review and meta-analysis of randomized control trials comparing cognitive outcome in patients undergoing CABG surgery on- or off-pump as assessed by continuous measures from a battery of 7 psychometric tests.

Setting: Multi-institutional centers performing CABG surgery.

Participants: Patients with coronary artery disease requiring CABG surgery.

Interventions: CABG surgery with or without CPB.

Measurements and main results: A structured literature search identified 13 randomized control trials that included a total of 2,405 patients. Results from 7 psychometric tests were grouped into early (≤3 months) and late (6-12 months) postoperative periods. No significant differences were found between on- and off-pump groups in any of the 7 psychometric tests in either the early (p range 0.21-0.78) or late (p range 0.09-0.93) postoperative period.

Conclusion: The results suggested that CPB may not be associated with cognitive decline that is associated with CABG surgery.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Cognition / physiology*
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology
  • Coronary Artery Bypass, Off-Pump / methods*
  • Endpoint Determination
  • Humans
  • Learning / physiology
  • Memory / physiology
  • Neuropsychological Tests
  • Postoperative Period*
  • Psychometrics
  • Publication Bias
  • Randomized Controlled Trials as Topic
  • Trail Making Test
  • Treatment Outcome