BACKGROUND: Although a lot of randomized trials of off-pump coronary artery bypass grafting (CABG) versus on-pump CABG were conducted, the majority of them reported only early outcomes. Previous meta-analyses of a few randomized trials found no differences for 1-year to 2-year mortality. METHODS: We focused late (> or = 1 year) all-cause mortality and performed a meta-analysis of randomized controlled trials of off-pump versus on-pump CABG. The MEDLINE, the EMBASE, and the Cochrane Central Register of Controlled Trials were searched using PubMed and OVID. For each study, data regarding all-cause mortality in both the off-pump and on-pump groups were used to generate risk ratios (RRs) and 95% confidence intervals. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic RRs in both fixed-effects and random-effects models. RESULTS: Our search identified 11 results of 12 randomized trials (4,326 patients) of off-pump versus on-pump CABG. Pooled analysis demonstrated a statistically significant increase in midterm all-cause mortality by a factor of 1.37 with off-pump relative to on-pump CABG (RR, 1.373; 95% confidence interval, 1.043 to 1.808). Exclusion of any single result, except for the largest (>2,000 patients) trial, from the analysis did not substantively alter the overall result of our analysis. Eliminating the largest trial demonstrated a statistically nonsignificant benefit of on-pump over off-pump CABG for midterm all-cause mortality (RR, 1.344; 95% confidence interval, 0.952 to 1.896). CONCLUSIONS: The results of our analysis suggest that off-pump CABG may increase late all-cause mortality by a factor of 1.37 over on-pump CABG. Longer term mortality from randomized trials of off-pump versus on-pump CABG is needed. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Although a lot of randomized trials of off-pump coronary artery bypass grafting (CABG) versus on-pump CABG were conducted, the majority of them reported only early outcomes. Previous meta-analyses of a few randomized trials found no differences for 1-year to 2-year mortality. METHODS: We focused late (> or = 1 year) all-cause mortality and performed a meta-analysis of randomized controlled trials of off-pump versus on-pump CABG. The MEDLINE, the EMBASE, and the Cochrane Central Register of Controlled Trials were searched using PubMed and OVID. For each study, data regarding all-cause mortality in both the off-pump and on-pump groups were used to generate risk ratios (RRs) and 95% confidence intervals. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic RRs in both fixed-effects and random-effects models. RESULTS: Our search identified 11 results of 12 randomized trials (4,326 patients) of off-pump versus on-pump CABG. Pooled analysis demonstrated a statistically significant increase in midterm all-cause mortality by a factor of 1.37 with off-pump relative to on-pump CABG (RR, 1.373; 95% confidence interval, 1.043 to 1.808). Exclusion of any single result, except for the largest (>2,000 patients) trial, from the analysis did not substantively alter the overall result of our analysis. Eliminating the largest trial demonstrated a statistically nonsignificant benefit of on-pump over off-pump CABG for midterm all-cause mortality (RR, 1.344; 95% confidence interval, 0.952 to 1.896). CONCLUSIONS: The results of our analysis suggest that off-pump CABG may increase late all-cause mortality by a factor of 1.37 over on-pump CABG. Longer term mortality from randomized trials of off-pump versus on-pump CABG is needed. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Authors: Paula Carmona; Federico Paredes; Eva Mateo; Armando V Mena-Durán; Fernando Hornero; Juan Martínez-León Journal: Interact Cardiovasc Thorac Surg Date: 2016-02-16
Authors: Lakhmir S Chawla; Yue Zhao; Fredrick C Lough; Elizabeth Schroeder; Michael G Seneff; J Matthew Brennan Journal: J Am Soc Nephrol Date: 2012-05-17 Impact factor: 10.121
Authors: G Landoni; J G Augoustides; F Guarracino; F Santini; M Ponschab; D Pasero; R N Rodseth; G Biondi-Zoccai; G Silvay; L Salvi; E Camporesi; M Comis; M Conte; S Bevilacqua; L Cabrini; C Cariello; F Caramelli; V De Santis; P Del Sarto; D Dini; A Forti; N Galdieri; G Giordano; L Gottin; M Greco; E Maglioni; L Mantovani; A Manzato; M Meli; G Paternoster; D Pittarello; N K Rana; L Ruggeri; V Salandin; F Sangalli; M Zambon; M Zucchetti; E Bignami; O Alfieri; A Zangrillo Journal: HSR Proc Intensive Care Cardiovasc Anesth Date: 2011
Authors: Chuntao Wu; Fabian T Camacho; Alfred T Culliford; Jeffrey P Gold; Andrew S Wechsler; Robert S D Higgins; Stephen J Lahey; Craig R Smith; Desmond Jordan; Edward L Hannan Journal: Circ Cardiovasc Qual Outcomes Date: 2012-01-10