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

Letter to the Editor

Reply to the Editor

Hisato Takagi, MD, PhD, Norikazu Kawai, MD, Takuya Umemoto, MD, PhD

Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan

We appreciate Drs Motallebzadeh and Jahangiri's letter to the editor regarding our meta-analysis1Go of randomized controlled trials of neurocognitive decline after off-pump versus on-pump coronary artery bypass graft surgery. Although the definitions of neurocognitive decline varied among the trials, as mentioned in their letter, we could not but include only studies reporting neurocognitive dysfunction dichotomously because there is no standard definition for neurocognitive dysfunction. We excluded a randomized controlled trial by Dr Motallebzadeh and associates2Go in our meta-analysis1Go because it did not report neurocognitive dysfunction dichotomously, and all except for the trial did not report composite neurocognitive scores. Dr Motallebzadeh and colleagues derived composite neurocognitive scores from all of the individual test scores and avoided categorizing patients dichotomously, thus treating the test scores as a continuous variable. If a number of randomized controlled trials reporting composite neurocognitive scores are published, we would like to perform another meta-analysis.

References

  1. Takagi H, Tanabashi T, Kawai N, Umemoto T. Cognitive decline after off-pump versus on-pump coronary artery bypass graft surgery: meta-analysis of randomized controlled trials. J Thorac Cardiovasc Surg 2007;134:512-513.[Free Full Text]
  2. Motallebzadeh R, Bland JM, Markus HS, Kaski JC, Jahangiri M. Neurocognitive function and cerebral emboli: randomized study of on-pump versus off-pump coronary artery bypass surgery. Ann Thorac Surg 2007;83:475-482.[Abstract/Free Full Text]




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