Review Article

Risk Factors Associated with Cognitive Decline after Cardiac Surgery: A Systematic Review

Table 4

Studies investigating whether biomarkers associated with inflammation and/or interventions aimed at reducing inflammation are associated with changes in cognition after surgery.

StudyStudy
design
Number of
patients
Marker for cerebral damageTime of assessmentOutcome

Fitch et al., 1999 [20]RCT35Inhibition of complement activation by specific antibody and no antibodyDischargeImproved cognition
Heyer et al., 2002 [21]RCT99Inhibition of complement activation by heparin-coated CPB5 days and 6 weeksImproved cognition
Baufreton et al., 2005 [19]RCT30Inhibition of complement activation by heparin-coated CPBDischargeImproved cognition
Skrabal et al., 2006 [22]RCT39PMEA-coated circuits and noncoated circuits7–10 daysImproved cognition
Wimmer-Greinecker et al., 1998 [56]Obsv.76>S-100 and NSE5 days and 2 monthsDecline
Jönsson et al., 1999 [57]Obsv.132>S-1002 weeks and 2 monthsDecline
Kilminster et al., 1999 [58]Obsv.130>S-1006–8 weeksDecline
Rasmussen et al., 1999 [59]Obsv.35>NSEDischarge and 3 monthsDecline
Derkach et al., 2000 [60]RCT27>S-100 and NSE (deep and mild hypothermic)6 monthsDecline
Diegeler et al., 2000 [61]RCT40>S-100 (on- and off-pump)1 weekDecline
Georgiadis et al., 2000 [62]Obsv.190>S-100DischargeDecline
Lloyd et al., 2000 [63]RCT125>S-100 (on- and off-pump)3 monthsDecline
Basile et al., 2001 [64]Obsv.16>S-100 and NSE6 monthsDecline
Rasmussen et al., 2002 [65]Obsv.15>NSEDischarge and 3 monthsDecline
Farsak et al., 2003 [66]Obsv.50>S-100DischargeDecline
Mathew et al., 2003 [67]Obsv.460Reduced preoperative endotoxin immunity6 weeksDecline
Jönsson et al., 2004 [68]Obsv.56>S-1006 monthsDecline
Kofke et al., 2004 [69]Obsv.28Apo epsilon 4 allele, >S-1008 and 24 hrsDecline
Snyder-Ramos et al., 2004 [70]Obsv.64>S-100 and NSEThroughout 7 daysDecline
Kálmán et al., 2006 [71]Obsv.14>Cytokine interleukin-61 week and 6 monthsDecline
Ramlawi et al., 2006 [72]Obsv.42>C-reactive protein6 hours and 4 daysDecline
Lazibat et al., 2012 [24]Obsv.62>S-1002 daysDecline
Bayram et al., 2013 [25]Obsv.64>S-1001 weekDecline
Westaby et al., 2001 [26]Obsv.1001>S-100 and NSE5 days and 3 monthsNo difference
Mathew et al., 2005 [73]Obsv.440Statin treatment6 weeksNo difference
Plaschke et al., 2013 [74]Obsv.151Preoperative serum anticholinergic activity3 monthsNo difference

NSE: neuron-specific enolase, PMEA: poly-2-methoxyethylacrylate, and Obsv.: observational.