van Dijk Diederik, Moons Karel G M, Nathoe Hendrik M, van Aarnhem Egidius H L, Borst Cornelius, Keizer Annemieke M A, Kalkman Cor J, Hijman Ron
Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Ann Thorac Surg. 2008 Jan;85(1):60-4. doi: 10.1016/j.athoracsur.2007.08.068.
Patients with coronary artery disease who underwent coronary artery bypass graft surgery have a high risk of cognitive decline 5 years after the procedure. It is conceivable that this is not caused by the operation, but by natural aging.
Psychologists repeatedly administered a battery of seven neuropsychological tests with eight main variables to 112 subjects without known coronary artery disease, with a time interval of 5 years. Cognitive decline was defined as deterioration in performance beyond normal variation in at least two of the eight main variables. The incidence of cognitive decline in the control subjects was compared with the incidence of cognitive decline in the 281 participants of the Octopus Study, who underwent coronary artery bypass graft surgery 5 years earlier. Patients and control subjects were age-matched.
After 5 years, cognitive outcome could be determined in 99 of 112 control subjects (88%) and 240 of 281 coronary artery bypass graft surgery patients (85%). Cognitive decline was present in 82 (34.2%) of 240 coronary artery bypass graft surgery patients and in 16 (16.2%) of 99 control subjects (crude odds ratio, 2.69; 95% confidence interval, 1.48 to 4.90). However, after correction for differences in age, sex, education, and baseline comorbidity between the patients and the control subjects, the odds ratio was 1.37 (95% confidence interval, 0.65 to 2.92).
We were unable to demonstrate that patients who underwent coronary artery bypass graft surgery have more cognitive decline after 5 years than control subjects without coronary artery disease.
接受冠状动脉搭桥手术的冠心病患者在术后5年有较高的认知功能下降风险。可以想象，这并非由手术引起，而是自然衰老所致。
心理学家对112名无已知冠状动脉疾病的受试者重复进行了一系列包含8个主要变量的7项神经心理学测试，时间间隔为5年。认知功能下降被定义为8个主要变量中至少2个变量的表现恶化超出正常变异范围。将对照组受试者的认知功能下降发生率与章鱼研究中281名参与者的认知功能下降发生率进行比较，这些参与者在5年前接受了冠状动脉搭桥手术。患者和对照组受试者年龄匹配。
5年后，112名对照组受试者中有99名（88%）以及281名冠状动脉搭桥手术患者中有240名（85%）的认知结果可被确定。240名冠状动脉搭桥手术患者中有82名（34.2%）出现认知功能下降，99名对照组受试者中有16名（16.2%）出现认知功能下降（粗比值比为2.69；95%置信区间为1.48至4.90）。然而，在对患者和对照组受试者之间的年龄、性别、教育程度和基线合并症差异进行校正后，比值比为1.37（95%置信区间为0.65至2.92）。
我们无法证明接受冠状动脉搭桥手术的患者在5年后比无冠状动脉疾病的对照组受试者有更多的认知功能下降。
