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Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery
Sebastian Holinski1, Benjamin Claus, Nour Alaaraj
1Department of Cardiovascular Surgery, Charite Hospital, Medical University, Berlin, Germany. sebastian.holinski@charite.de
Insights
Piracetam shows cerebroprotective effects, reducing cognitive decline after coronary artery bypass surgery. This study found piracetam significantly improved cognitive performance in patients undergoing cardiopulmonary bypass.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Cognitive dysfunction is a potential complication following cardiac surgery involving cardiopulmonary bypass.
- Investigating neuroprotective agents is crucial for improving patient outcomes after such procedures.
Purpose of the Study:
- To evaluate the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery (CABG).
- To assess the impact of piracetam on early postoperative cognitive decline in patients who underwent cardiopulmonary bypass.
Main Methods:
- A double-blind, randomized study involving 120 patients scheduled for elective CABG.
- Patients received either 12g of piracetam or a placebo preoperatively.
- Cognitive function was assessed using six neuropsychological subtests preoperatively and on postoperative day three.
Main Results:
- No significant preoperative differences in cognitive function were observed between the piracetam and placebo groups.
- Both groups experienced a significant decline in cognitive function postoperatively.
- Piracetam administration resulted in significantly better postoperative cognitive performance and less cognitive decline compared to placebo.
Conclusions:
- Piracetam demonstrates a cerebroprotective effect in patients undergoing CABG with cardiopulmonary bypass.
- Piracetam effectively mitigates the early postoperative decline in neuropsychological abilities.
Background:
Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass.
Material/Methods:
Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g 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 the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis.
Results:
A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; p<0.0005 and piracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; p<0.0005). However, the piracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (p<0.0005).
Conclusions:
Piracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.
