OBJECTIVE: Multiple reports demonstrate that off-pump surgery reduces the early morbidity associated with coronary artery bypass grafting. To determine if there are any differences in later outcomes, we compared midterm results of propensity-matched patients who underwent off- and on-pump coronary artery bypass grafting. METHODS: From January 1997 to July 2000, 481 patients underwent off-pump coronary artery bypass grafting and 3231 underwent on-pump coronary artery bypass grafting. Propensity matching was used to match 406 patients from each group. Previously, the propensity-matched off-pump patients were found to have had significantly fewer bypass grafts. These 812 patients were followed for time-related events, including death, myocardial infarction, percutaneous coronary intervention, coronary reoperation, and the combined end point of all-cause mortality, myocardial infarction, and all coronary reintervention. Follow-up was 95% complete. RESULTS: At 4 years, survival was 87.5% after off-pump and 91.2% after on-pump coronary artery bypass grafting (P =.2); freedom from myocardial infarction was 92.6% and 95.7% (P =.7), respectively; freedom from percutaneous coronary intervention was 94.3% and 95.5% (P =.9), respectively; freedom from coronary reoperation was 98.1% and 99.0% (P =.4), respectively; and freedom from the combined end point of all-cause mortality, myocardial infarction, and coronary reintervention was 75.2% and 82.9% (P =.14), respectively. CONCLUSIONS: Off-pump and on-pump coronary artery bypass grafting results in equivalent midterm outcomes. Fewer bypass grafts in the off-pump patients did not decrease survival or increase ischemic events at 4 years.
OBJECTIVE: Multiple reports demonstrate that off-pump surgery reduces the early morbidity associated with coronary artery bypass grafting. To determine if there are any differences in later outcomes, we compared midterm results of propensity-matched patients who underwent off- and on-pump coronary artery bypass grafting. METHODS: From January 1997 to July 2000, 481 patients underwent off-pump coronary artery bypass grafting and 3231 underwent on-pump coronary artery bypass grafting. Propensity matching was used to match 406 patients from each group. Previously, the propensity-matched off-pump patients were found to have had significantly fewer bypass grafts. These 812 patients were followed for time-related events, including death, myocardial infarction, percutaneous coronary intervention, coronary reoperation, and the combined end point of all-cause mortality, myocardial infarction, and all coronary reintervention. Follow-up was 95% complete. RESULTS: At 4 years, survival was 87.5% after off-pump and 91.2% after on-pump coronary artery bypass grafting (P =.2); freedom from myocardial infarction was 92.6% and 95.7% (P =.7), respectively; freedom from percutaneous coronary intervention was 94.3% and 95.5% (P =.9), respectively; freedom from coronary reoperation was 98.1% and 99.0% (P =.4), respectively; and freedom from the combined end point of all-cause mortality, myocardial infarction, and coronary reintervention was 75.2% and 82.9% (P =.14), respectively. CONCLUSIONS: Off-pump and on-pump coronary artery bypass grafting results in equivalent midterm outcomes. Fewer bypass grafts in the off-pump patients did not decrease survival or increase ischemic events at 4 years.
Authors: Gordon E Pate; Min Gao; Lillian Ding; Ronald G Carere; Frank O Tyers; Robert I Hayden Journal: Can J Cardiol Date: 2006-12 Impact factor: 5.223
Authors: Whady Hueb; Neuza H M Lopes; Bernard J Gersh; Cláudio C Castro; Felipe S Paulitsch; Sergio A Oliveira; Luis A Dallan; Alexandre C Hueb; Noedir A Stolf; José A F Ramires Journal: Trials Date: 2008-08-28 Impact factor: 2.279