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CompletedNCT00189215Updated Dec 4, 2007

Long-Term Cognitive Decline After Coronary Artery Bypass Grafting: is Off-Pump Surgery Beneficial?

A Phase 4 interventional study of cardiac stabilizer instead of cardiopulmonary bypass in Coronary Artery Disease, Cardiopulmonary Bypass and Cognition Disorders, sponsored by UMC Utrecht. Completed at 1 site in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2007-12-04.

Sponsored by UMC Utrecht · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
280
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Coronary artery bypass surgery is associated with postoperative cognitive decline, which has largely been attributed to the use of the heart lung machine. We hypothesized that long-term cognitive outcome may improve by avoiding the heart lung machine. The objective of the present study is to compare the effect of coronary bypass surgery with and without heart lung machine on cognitive and clinical outcome, five years after surgery.

Read the detailed description

Background:

Coronary artery bypass surgery is associated with postoperative cognitive decline, which has largely been attributed to the use of cardiopulmonary bypass (CPB). A large recent study by Newman et al demonstrated that the incidence of cognitive decline was 24% at six months after surgery, but it increased to 42% at five years. In the recently conducted Octopus Randomized Trial, cognitive decline at three months after surgery was present in 29% of the patients operated with CPB. In the patients operated without CPB, the incidence was 21%, i.e. only slightly better.

Hypothesis:

Improvement of cognitive outcome by avoiding cardiopulmonary bypass will become more apparent five years after surgery, compared to three months after surgery.

Study objectives:

The objective of the present study is to compare the effect of coronary bypass surgery with and without cardiopulmonary bypass on cognitive and clinical outcome, five years after surgery.

Methods:

The 281 participants of the Octopus Study, who were operated on between March 1998 and August 2000 and randomized to off-pump or on-pump coronary bypass surgery, will be invited for an additional assessment of their cognitive and clinical status and quality of life, five years after surgery. Patients will undergo a battery of ten neuropsychologic tests to determine their cognitive status. Clinical status will be assessed by an interview. Questionnaires will be used to measure quality of life.

02

Conditions studied

  • Coronary Artery Disease
  • Cardiopulmonary Bypass
  • Cognition Disorders

Keywords

  • coronary artery disease
  • cardiopulmonary bypass
  • cognition disorders
03

In context

Coronary Artery Disease

5,676 studies on the registry are indexed under Coronary Artery Disease; 958 are open to participants now.

This study's enrollment of 280 is above the median of 123 across 3,481 interventional studies indexed under Coronary Artery Disease.

Browse Coronary Artery Disease studies →

Lead sponsor

UMC Utrecht is the lead sponsor of 363 studies on the registry; 81 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • indication for (first-time) coronary artery bypass surgery
  • off-pump CABG considered technically possible

Exclusion criteria

Exclusion Criteria:

  • concomitant valve surgery
  • unable to complete neuropsychological testing
  • life expectancy less than 1 year
05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single
Enrollment
280 participants

Interventions

  • Devicecardiac stabilizer instead of cardiopulmonary bypass
06

What researchers measure

Primary outcomes

  1. cognitive decline 5 year after the index treatment

Secondary outcomes

  1. -freedom from cardiovascular events (i.e. mortality, stroke, myocardial infarction, re-CABG, or PTCA

  2. -recurrence of angina

  3. -use of anti-anginal drugs

  4. -quality of life (SF-36 and EuroQuol

07

Study locations

1 site
  • University Medical Center, Department of Anesthesiology
    Utrecht, Utrecht 3584 CX, Netherlands
08

References and documents

Publications

  • van Dijk D, Nierich AP, Eefting FD, Buskens E, Nathoe HM, Jansen EW, Borst C, Knape JT, Bredee JJ, Robles de Medina EO, Grobbee DE, Diephuis JC, de Jaegere PP. The Octopus Study: rationale and design of two randomized trials on medical effectiveness, safety, and cost-effectiveness of bypass surgery on the beating heart. Control Clin Trials. 2000 Dec;21(6):595-609. doi: 10.1016/s0197-2456(00)00103-3. PubMed 11146152 ↗
  • Van Dijk D, Jansen EW, Hijman R, Nierich AP, Diephuis JC, Moons KG, Lahpor JR, Borst C, Keizer AM, Nathoe HM, Grobbee DE, De Jaegere PP, Kalkman CJ; Octopus Study Group. Cognitive outcome after off-pump and on-pump coronary artery bypass graft surgery: a randomized trial. JAMA. 2002 Mar 20;287(11):1405-12. doi: 10.1001/jama.287.11.1405. PubMed 11903027 ↗
  • Nathoe HM, van Dijk D, Jansen EW, Suyker WJ, Diephuis JC, van Boven WJ, de la Riviere AB, Borst C, Kalkman CJ, Grobbee DE, Buskens E, de Jaegere PP; Octopus Study Group. A comparison of on-pump and off-pump coronary bypass surgery in low-risk patients. N Engl J Med. 2003 Jan 30;348(5):394-402. doi: 10.1056/NEJMoa021775. PubMed 12556542 ↗
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Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Mar 1998 and a completion of Dec 2005. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 13, 2005
First posted
Sep 16, 2005
Start
Mar 1998
Completion
Dec 2005
Last update
Dec 4, 2007
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
No changes since tracking began. The registry record was last updated on Dec 4, 2007, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00189215
Lead sponsor
UMC Utrecht
Collaborators
International Anesthesia Research Society (IARS)
First posted
Sep 16, 2005
Start date
Mar 1998
Completion
Dec 2005
Last update
Dec 4, 2007

Study contacts

Cor J Kalkman, MD, PhD
study director · UMC Utrecht, The Netherlands
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Mar 2005. You cannot join it, but the record below documents what was studied.

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