Anesthesiology, Author Interviews, Cognitive Issues, Heart Disease, JAMA, Surgical Research, UCSF / 22.05.2021

MedicalResearch.com Interview with: Elizabeth L. Whitlock, MD, MSc John W. Severinghaus Assistant Professor In Residence Anesthesia & Perioperative Care UCSF Medical Center MedicalResearch.com: What is the background for this study? Response: We have known for a while that, rarely, some older adults suffer substantial, durable cognitive decline after surgery, particularly after coronary artery bypass grafting (CABG) surgery; a larger proportion experience a decline in cognitive test performance which doesn't necessarily affect function, but which has caused concern among researchers. This cognitive decline was attributed, in part, to the cardiac bypass pump. ​Many of the studies had methodological limitations which made it difficult to be sure that the cognitive change was due to surgery and not due more generally to heart problems or atherosclerotic disease, which may also imply cerebrovascular atherosclerosis. Using a large database of older adults who undergo regular cognitive testing, we identified individuals who underwent CABG and compared them to those who underwent percutaneous coronary intervention (PCI), a minimally invasive, non-surgical method of opening blocked coronary arteries. This allowed us to model the rate of memory decline before surgery - which hadn't been done in previous studies - and compare it to the rate of memory decline after surgery in older adults who had serious heart disease (some of whom were treated with CABG, and some treated with PCI). (more…)