Effects of Off-Pump and On-Pump Coronary-Artery Bypass Grafting at 1 Year Academic Article uri icon

  •  
  • Overview
  •  
  • Research
  •  
  • Identity
  •  
  • Additional Document Info
  •  
  • View All
  •  

abstract

  • BACKGROUND: Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outcomes at 1 year. METHODS: We enrolled 4752 patients with coronary artery disease who were scheduled to undergo CABG and randomly assigned them to undergo the procedure off-pump or on-pump. Patients were enrolled at 79 centers in 19 countries. We assessed quality of life and cognitive function at discharge, at 30 days, and at 1 year and clinical outcomes at 1 year. RESULTS: At 1 year, there was no significant difference in the rate of the primary composite outcome between off-pump and on-pump CABG (12.1% and 13.3%, respectively; hazard ratio with off-pump CABG, 0.91; 95% confidence interval [CI], 0.77 to 1.07; P=0.24). The rate of the primary outcome was also similar in the two groups in the period between 31 days and 1 year (hazard ratio, 0.79; 95% CI, 0.55 to 1.13; P=0.19). The rate of repeat coronary revascularization at 1 year was 1.4% in the off-pump group and 0.8% in the on-pump group (hazard ratio, 1.66; 95% CI, 0.95 to 2.89; P=0.07). There were no significant differences between the two groups at 1 year in measures of quality of life or neurocognitive function. CONCLUSIONS: At 1 year after CABG, there was no significant difference between off-pump and on-pump CABG with respect to the primary composite outcome, the rate of repeat coronary revascularization, quality of life, or neurocognitive function. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294.).

authors

  • Morillo, Carlos Arturo
  • Lamy, Andre
  • Devereaux, Philip
  • Prabhakaran, Dorairaj
  • Taggart, David P
  • Hu, Shengshou
  • Paolasso, Ernesto
  • Straka, Zbynek
  • Piegas, Leopoldo S
  • Akar, Ahmet Ruchan
  • Jain, Anil R
  • Noiseux, Nicolas
  • Padmanabhan, Chandrasekar
  • Bahamondes, Juan-Carlos
  • Novick, Richard J
  • Vaijyanath, Prashant
  • Reddy, Sukesh Kumar
  • Tao, Liang
  • Olavegogeascoechea, Pablo A
  • Airan, Balram
  • Sulling, Toomas-Andres
  • Whitlock, Richard
  • Ou, Yongning
  • Pogue, Janice
  • Chrolavicius, Susan
  • Yusuf, Salim

publication date

  • March 28, 2013