A longitudinal study by Johns Hopkins’ cardiac surgeons, cardiologists, and neurologists, led by Guy M. McKhann, M.D., was initiated 13 years ago to determine whether coronary artery bypass graft surgery causes cognitive decline in patients, as reported anecdotally. The study was designed to answer this question definitively, by comparing cognitive outcomes of cardiovascular patients treated surgically to those treated medically, and to heart healthy “control” adults. With evidence from 227 heart bypass patients, the research determined that underlying vascular disease, rather than coronary artery bypass graft surgery, is primarily responsible for the long-term decline in cognitive functioning in people with coronary artery disease. Further, it was determined that heart-lung machines used to pump blood during surgery when the heart was stopped did not cause later cognitive decline. Dr. McKhann writes that three steps should be taken to complete the studies. A copy of his letter is attached. Attached is a copy of the cover page (with link) of the August 2009 issue of Annals of Thoracic Surgery. Also attached is a copy of the August 31, 2009, The Johns Hopkins Gazette.