A meta-analysis of cognitive outcome following coronary artery bypass graft surgery

Abstract

Coronary artery bypass graft (CABG) surgery is an established treatment for complex coronary artery disease. There is a widely held belief that cognitive decline presents post-operatively. A consensus statement of core neuropsychological tests was published in 1995 with the intention of guiding investigation into this issue. We conducted a meta-analysis evaluating the evidence for cognitive decline post-CABG surgery. Twenty-eight published studies, accumulating data from up to 2043 patients undergoing CABG surgery, were included. Results were examined at 'very early' (<2 weeks), 'early' (3 months) and 'late' (6-12 months) time periods post-operatively. Two of the four tests suggested an initial very early decrease in psychomotor speed that was not present at subsequent testing. Rather, the omnibus data indicated subtle improvement in function relative to pre-operative baseline testing. Our findings suggest improvement in cognitive function in the first year following CABG surgery. This is contrary to the more negative interpretation of results of some individual publications included in our review, which may reflect poor outcomes in a few patients and/or methodological issues.