Neuroinflammation in Cognitive Decline Post-cardiac Surgery

Inclusion Criteria:

• Age > 50 years
• Planned for on-pump coronary artery bypass grafting surgery
• High-affinity binder or mixed-affinity binders based on rs6971 polymorphism for TSPO
• Chronic use of statins (defined as pre-hospital use)

Exclusion Criteria:

• Previous cardiac surgery.
• Pregnancy or wish to become pregnant within 2 weeks after PET-CT scan
• Contra-indication to undergo a PET/CT or MRI scan, including claustrophobia.
• Low-affinity binder based on rs6971 polymorphism for TSPO, or unable to determiners6971 polymorphism.
• Patients with cognitive disorders that have not recovered enough to be able tounderstand the study leaflets and information for participation.
• Brain or spinal surgery within the last 6 months.
• Meningitis or brain infection within the last 6 months.
• Pre-existing dementia or neurodegenerative disease or cognitive impairment interferingwith the ability to understand informational material about this research project.
• Presence of a CSF catheter or shunt.
• Patients with known brain tumors.
• Patients with brain injury (e.g. acute stroke, or subarachnoid hemorrhage) within thelast 6 months.
• Severe brain trauma in previous medical history.
• Chronic (>2 weeks) use of immunosuppressive agents (see table 3.3.A).
• Concomitant diseases resulting in severe immunosuppression (e.g. HIV).
• Auto-immune or auto-inflammatory disease
• Active infection < 2 weeks prior to inclusion (defined as fever >38.5 or antibiotictreatment)
• Kidney failure, defined by a MDRD-GFR<15 ml/min/1.73m2
• Known contrast allergy for gadolinium
• Chronic use of neuroleptics, defined as pre-hospital use.
• Patients that do not speak Dutch or have disabilities that prevent accurate deliriumdiagnosis.
• Analphabetic patients.
• No written informed consent obtained.