Neuropsychological outcome after percutaneous coronary intervention or coronary artery bypass grafting -: Results from the Stent or Surgery (SoS) Trial

被引:69
作者
Währborg, P [1 ]
Booth, JE
Clayton, T
Nugara, F
Pepper, J
Weintraub, WS
Sigwart, U
Stables, RH
机构
[1] Sahlgrenska Univ Hosp, Dept Cardiol, S-41345 Gothenburg, Sweden
[2] Royal Brompton Hosp, London SW3 6LY, England
[3] London Sch Hyg & Trop Med, London WC1, England
[4] Emory Univ, Sch Med, Atlanta, GA USA
[5] Univ Geneva, Geneva, Switzerland
[6] Ctr Cardiothorac, Liverpool, Merseyside, England
关键词
angioplasty; cognition; bypass; coronary artery; neuropsychology; stents;
D O I
10.1161/01.CIR.0000148366.80443.2B
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - Coronary artery bypass surgery (CABG) has been associated with a range of neurological and neuropsychological complications from stroke to cognitive problems such as memory and problem solving disturbance. However, little is known about the impact of percutaneous coronary intervention (PCI) on neuropsychological outcome. Methods and Results - In the Stent or Surgery Trial (SoS), 988 patients were randomized in equal proportions between PCI supported by stent implantation and CABG. As a substudy of this trial, we undertook an evaluation of neurological and neuropsychological outcomes after intervention. A clinical examination and neuropsychological assessment consisting of 5 tests ( Digit Span Forwards and Backwards, Visual Reproduction, Bourdon, and Block Design) were performed at baseline and 6 and 12 months after the procedure. A total of 145 patients were included in the substudy analysis: 77 in the PCI group and 68 in the CABG group. One patient in the PCI arm had a stroke. There was no significant difference between treatment groups at 6 and 12 months for any of the 5 tests. The mean change from baseline was also similar in both groups. Conclusions - We were not able to demonstrate an important and significant difference in neuropsychological outcome in patients treated with different revascularization strategies. This important finding needs to be examined in further research.
引用
收藏
页码:3411 / 3417
页数:7
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