Neurocognitive outcomes are not improved by 17β-estradiol in postmenopausal women undergoing cardiac surgery

Charles W. Hogue, Kenneth Freedland, Tamara Hershey, Robert Fucetola, Abullah Nassief, Benico Barzilai, Betsy Thomas, Stanley Birge, David Dixon, Kenneth B. Schechtman, Victor G. Dávila-Román

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE - Neurocognitive dysfunction is an important source of patient morbidity and mortality after cardiac surgery that may disproportionately affect postmenopausal women. 17β-Estradiol limits the extent of ischemic neuronal injury in a variety of experimental models. The purpose of this study was to evaluate whether perioperative administration of 17β-estradiol to postmenopausal women reduces the frequency of neurocognitive dysfunction after cardiac surgery. METHODS - One hundred seventy-four postmenopausal women not on estrogen replacement therapy who were undergoing primary coronary artery bypass graft surgery and/or valve surgery with cardiopulmonary bypass were prospectively randomized to receive in a double-blinded manner either 17β-estradiol or placebo beginning the day before surgery and continuing for 5 days postoperatively. The patients were evaluated before and after surgery with the National Institutes of Health Stroke Scale and a psychometric test battery. RESULTS - There were no differences in the frequency of neurocognitive dysfunction (primary outcome) between patients randomized to perioperative 17β-estradiol (n=86) and those randomized to placebo (n=88) 4 to 6 weeks after surgery (17β-estradiol, 22.4% versus placebo, 21.4%, P=0.45). The mean scores on tests of psychomotor speed were worse in women in the 17β-estradiol group than in the placebo group at the 4- to 6-week (P=0.005) postoperative testing sessions. CONCLUSIONS - Perioperative treatment with 17β-estradiol did not result in improved neurocognitive outcomes in postmenopausal women undergoing cardiac surgery.

Original languageEnglish (US)
Pages (from-to)2048-2054
Number of pages7
JournalStroke
Volume38
Issue number7
DOIs
StatePublished - Jul 1 2007

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Keywords

  • Cardiac surgery
  • Cognitive impairment
  • Estrogen
  • Neuroprotective agents

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Hogue, C. W., Freedland, K., Hershey, T., Fucetola, R., Nassief, A., Barzilai, B., Thomas, B., Birge, S., Dixon, D., Schechtman, K. B., & Dávila-Román, V. G. (2007). Neurocognitive outcomes are not improved by 17β-estradiol in postmenopausal women undergoing cardiac surgery. Stroke, 38(7), 2048-2054. https://doi.org/10.1161/STROKEAHA.106.480426