Cerebroprotective Effect of Piracetam in Patients Undergoing Open Heart Surgery
Objectives: Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cog...
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| Veröffentlicht in: | Annals of Thoracic and Cardiovascular Surgery 2011/04/25, Vol.17(2), pp.137-142 |
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| container_title | Annals of Thoracic and Cardiovascular Surgery |
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| creator | Holinski, Sebastian Claus, Benjamin Alaaraj, Nour Dohmen, Pascal Maria Neumann, Konrad Uebelhack, Ralf Konertz, Wolfgang |
| description | Objectives: Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. Methods: Patients scheduled for elective open heart surgery were randomized to the piracetam or placebo group in a double-blind study. Patients received 12 g of piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on day 3, postoperatively. To assess the overall cognitive function and the degree of cognitive decline across all tests after the surgery, we combined the six test-scores by principal component analysis. Results: A total of 88 patients with a mean age of 67 years were enrolled into the study. The mean duration of CPB was 110 minutes. Preoperative clinical parameters and overall cognitive functions were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed deterioration of cognitive function in both groups (piracetam: preoperative 0.19 ± 0.97 vs. postoperative -0.97 ± 1.38, p |
| doi_str_mv | 10.5761/atcs.oa.10.01545 |
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Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. Methods: Patients scheduled for elective open heart surgery were randomized to the piracetam or placebo group in a double-blind study. Patients received 12 g of piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on day 3, postoperatively. To assess the overall cognitive function and the degree of cognitive decline across all tests after the surgery, we combined the six test-scores by principal component analysis. Results: A total of 88 patients with a mean age of 67 years were enrolled into the study. The mean duration of CPB was 110 minutes. Preoperative clinical parameters and overall cognitive functions were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed deterioration of cognitive function in both groups (piracetam: preoperative 0.19 ± 0.97 vs. postoperative -0.97 ± 1.38, p <0.0005 and placebo: preoperative -0.14 ± 0.98 vs. postoperative -1.35 ± 1.23, p <0.0005). Patients taking piracetam did not perform better than those taking placebo, and both groups had the same decline of overall cognitive function (p = 0.955). Conclusion: Piracetam had no cerebroprotective effect in patients undergoing open heart surgery. Unlike the patients who underwent coronary surgery, piracetam did not reduce the early postoperative decline of neuropsychological abilities in heart valve patients.</description><identifier>ISSN: 1341-1098</identifier><identifier>EISSN: 2186-1005</identifier><identifier>DOI: 10.5761/atcs.oa.10.01545</identifier><identifier>PMID: 21597409</identifier><language>eng</language><publisher>Japan: The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Attention - drug effects ; cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; cardiopulmonary bypass ; Cardiopulmonary Bypass - adverse effects ; Cognition - drug effects ; cognition disorders ; Cognition Disorders - prevention & control ; Cognition Disorders - psychology ; Double-Blind Method ; Germany ; Humans ; Memory, Short-Term - drug effects ; Middle Aged ; neuroprotective agents ; Neuroprotective Agents - therapeutic use ; Neuropsychological Tests ; Piracetam - therapeutic use ; Principal Component Analysis ; Recognition (Psychology) - drug effects ; Time Factors ; Treatment Outcome</subject><ispartof>Annals of Thoracic and Cardiovascular Surgery, 2011/04/25, Vol.17(2), pp.137-142</ispartof><rights>2011 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-94611b9ea2eb8ffebf5a7ee903a767e77063b2f967943635c7fb37824f3d0b873</citedby><cites>FETCH-LOGICAL-c528t-94611b9ea2eb8ffebf5a7ee903a767e77063b2f967943635c7fb37824f3d0b873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,1883,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21597409$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holinski, Sebastian</creatorcontrib><creatorcontrib>Claus, Benjamin</creatorcontrib><creatorcontrib>Alaaraj, Nour</creatorcontrib><creatorcontrib>Dohmen, Pascal Maria</creatorcontrib><creatorcontrib>Neumann, Konrad</creatorcontrib><creatorcontrib>Uebelhack, Ralf</creatorcontrib><creatorcontrib>Konertz, Wolfgang</creatorcontrib><title>Cerebroprotective Effect of Piracetam in Patients Undergoing Open Heart Surgery</title><title>Annals of Thoracic and Cardiovascular Surgery</title><addtitle>ATCS</addtitle><description>Objectives: Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. Methods: Patients scheduled for elective open heart surgery were randomized to the piracetam or placebo group in a double-blind study. Patients received 12 g of piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on day 3, postoperatively. To assess the overall cognitive function and the degree of cognitive decline across all tests after the surgery, we combined the six test-scores by principal component analysis. Results: A total of 88 patients with a mean age of 67 years were enrolled into the study. The mean duration of CPB was 110 minutes. Preoperative clinical parameters and overall cognitive functions were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed deterioration of cognitive function in both groups (piracetam: preoperative 0.19 ± 0.97 vs. postoperative -0.97 ± 1.38, p <0.0005 and placebo: preoperative -0.14 ± 0.98 vs. postoperative -1.35 ± 1.23, p <0.0005). Patients taking piracetam did not perform better than those taking placebo, and both groups had the same decline of overall cognitive function (p = 0.955). Conclusion: Piracetam had no cerebroprotective effect in patients undergoing open heart surgery. Unlike the patients who underwent coronary surgery, piracetam did not reduce the early postoperative decline of neuropsychological abilities in heart valve patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Attention - drug effects</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>cardiopulmonary bypass</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Cognition - drug effects</subject><subject>cognition disorders</subject><subject>Cognition Disorders - prevention & control</subject><subject>Cognition Disorders - psychology</subject><subject>Double-Blind Method</subject><subject>Germany</subject><subject>Humans</subject><subject>Memory, Short-Term - drug effects</subject><subject>Middle Aged</subject><subject>neuroprotective agents</subject><subject>Neuroprotective Agents - therapeutic use</subject><subject>Neuropsychological Tests</subject><subject>Piracetam - therapeutic use</subject><subject>Principal Component Analysis</subject><subject>Recognition (Psychology) - drug effects</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1341-1098</issn><issn>2186-1005</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkEtPAjEURhujEUT3rkx3rsB2On3M0hAQExJIlHXTKbfjEJjBtpjw7y2OEjf3kZz7tTkI3VMy4lLQJxNtGLVmlHZCec4vUD-jSgwpIfwS9SnLaZoL1UM3IWwIYUoIco16GeWFzEnRR4sxeCh9u_dtBBvrL8AT59KEW4eXtTcWotnhusFLE2toYsCrZg2-auumwos9NHgGxkf8dvAV-OMtunJmG-Dutw_Qajp5H8-G88XL6_h5PrQ8U3FY5ILSsgCTQanSe6XjRgIUhBkpJEhJBCszVwhZ5EwwbqUrmVRZ7tialEqyAXrsctPHPw8Qot7VwcJ2axpoD0EroQgjXPJEko60vg3Bg9N7X--MP2pK9MmiPlnUrTntPxbTycNv-KHcwfp88KctAdMO2IRoKjgDSURtt9AlUqmzU_mXfAbsh_EaGvYNjAiIWA</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>Holinski, Sebastian</creator><creator>Claus, Benjamin</creator><creator>Alaaraj, Nour</creator><creator>Dohmen, Pascal Maria</creator><creator>Neumann, Konrad</creator><creator>Uebelhack, Ralf</creator><creator>Konertz, Wolfgang</creator><general>The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2011</creationdate><title>Cerebroprotective Effect of Piracetam in Patients Undergoing Open Heart Surgery</title><author>Holinski, Sebastian ; Claus, Benjamin ; Alaaraj, Nour ; Dohmen, Pascal Maria ; Neumann, Konrad ; Uebelhack, Ralf ; Konertz, Wolfgang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-94611b9ea2eb8ffebf5a7ee903a767e77063b2f967943635c7fb37824f3d0b873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Attention - drug effects</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>cardiopulmonary bypass</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Cognition - drug effects</topic><topic>cognition disorders</topic><topic>Cognition Disorders - prevention & control</topic><topic>Cognition Disorders - psychology</topic><topic>Double-Blind Method</topic><topic>Germany</topic><topic>Humans</topic><topic>Memory, Short-Term - drug effects</topic><topic>Middle Aged</topic><topic>neuroprotective agents</topic><topic>Neuroprotective Agents - therapeutic use</topic><topic>Neuropsychological Tests</topic><topic>Piracetam - therapeutic use</topic><topic>Principal Component Analysis</topic><topic>Recognition (Psychology) - drug effects</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Holinski, Sebastian</creatorcontrib><creatorcontrib>Claus, Benjamin</creatorcontrib><creatorcontrib>Alaaraj, Nour</creatorcontrib><creatorcontrib>Dohmen, Pascal Maria</creatorcontrib><creatorcontrib>Neumann, Konrad</creatorcontrib><creatorcontrib>Uebelhack, Ralf</creatorcontrib><creatorcontrib>Konertz, Wolfgang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of Thoracic and Cardiovascular Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holinski, Sebastian</au><au>Claus, Benjamin</au><au>Alaaraj, Nour</au><au>Dohmen, Pascal Maria</au><au>Neumann, Konrad</au><au>Uebelhack, Ralf</au><au>Konertz, Wolfgang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebroprotective Effect of Piracetam in Patients Undergoing Open Heart Surgery</atitle><jtitle>Annals of Thoracic and Cardiovascular Surgery</jtitle><addtitle>ATCS</addtitle><date>2011</date><risdate>2011</risdate><volume>17</volume><issue>2</issue><spage>137</spage><epage>142</epage><pages>137-142</pages><issn>1341-1098</issn><eissn>2186-1005</eissn><abstract>Objectives: Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. Methods: Patients scheduled for elective open heart surgery were randomized to the piracetam or placebo group in a double-blind study. Patients received 12 g of piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on day 3, postoperatively. To assess the overall cognitive function and the degree of cognitive decline across all tests after the surgery, we combined the six test-scores by principal component analysis. Results: A total of 88 patients with a mean age of 67 years were enrolled into the study. The mean duration of CPB was 110 minutes. Preoperative clinical parameters and overall cognitive functions were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed deterioration of cognitive function in both groups (piracetam: preoperative 0.19 ± 0.97 vs. postoperative -0.97 ± 1.38, p <0.0005 and placebo: preoperative -0.14 ± 0.98 vs. postoperative -1.35 ± 1.23, p <0.0005). Patients taking piracetam did not perform better than those taking placebo, and both groups had the same decline of overall cognitive function (p = 0.955). Conclusion: Piracetam had no cerebroprotective effect in patients undergoing open heart surgery. Unlike the patients who underwent coronary surgery, piracetam did not reduce the early postoperative decline of neuropsychological abilities in heart valve patients.</abstract><cop>Japan</cop><pub>The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery</pub><pmid>21597409</pmid><doi>10.5761/atcs.oa.10.01545</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Attention - drug effects cardiac surgery Cardiac Surgical Procedures - adverse effects cardiopulmonary bypass Cardiopulmonary Bypass - adverse effects Cognition - drug effects cognition disorders Cognition Disorders - prevention & control Cognition Disorders - psychology Double-Blind Method Germany Humans Memory, Short-Term - drug effects Middle Aged neuroprotective agents Neuroprotective Agents - therapeutic use Neuropsychological Tests Piracetam - therapeutic use Principal Component Analysis Recognition (Psychology) - drug effects Time Factors Treatment Outcome |
| title | Cerebroprotective Effect of Piracetam in Patients Undergoing Open Heart Surgery |
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