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J Thorac Cardiovasc Surg 2008;135:1400-1401
© 2008 The American Association for Thoracic Surgery

Letter to the Editor

Meta-analysis of randomized controlled trials of cognitive decline after on-pump versus off-pump coronary artery bypass graft surgery

^a Department of Surgery, University of Cambridge, Cambridge, United Kingdom
^b Department of Cardiac Surgery, St George's Hospital Medical School, London, United Kingdom

The first 20% of the full text of this article appears below.

To the Editor:

We read with interest the meta-analysis of randomized studies of neurocognitive decline after on-pump versus off-pump coronary artery bypass graft surgery (CABG) by Takagi and colleagues.¹ The inclusion criteria comprised prospective randomized studies with the incidence of postoperative neurocognitive decline as the primary end point. However, there was significant clinical heterogeneity in the studies that were included in the meta-analysis. In particular, the definitions used to define neurocognitive decline between the trials varied markedly.^2,3 As a result, we question whether the incidences of neurocognitive decline can be reliably compared. Furthermore, studies that . . . [Full Text of this Article]