• Andre Lamy, Philip J Devereaux, Dorairaj Prabhakaran, Shengshou Hu, Leopoldo S Piegas, Zbynek Straka, Ernesto Paolasso, David Taggart, Fernando Lanas, A Ruchan Akar, Anil Jain, Nicolas Noiseux, Yongning Ou, Susan Chrolavicius, Jennifer Ng, and Salim Yusuf.
• Population Health Research Institute, Hamilton Health Sciences, McMaster University, Canada. lamya@mcmaster.ca
• Am. Heart J. 2012 Jan 1;163(1):1-6.

BackgroundUncertainty remains regarding the benefits and risks of the technique of operating on a beating heart (off pump) for coronary artery bypass grafting (CABG) surgery versus on-pump CABG. Prior trials had few events and relatively short follow-up. There is a need for a large randomized, controlled trial with long-term follow-up to inform both the short- and long-term impact of the 2 approaches to CABG.MethodsWe plan to randomize 4,700 patients in whom CABG is planned to undergo the procedure on pump or off pump. The coprimary outcomes are a composite of total mortality, myocardial infarction (MI), stroke, and renal failure at 30 days and a composite of total mortality, MI, stroke, renal failure, and repeat revascularization at 5 years. We will also undertake a cost-effectiveness analysis at 30 days and 5 years after CABG surgery. Other outcomes include neurocognitive dysfunction, recurrence of angina, cardiovascular mortality, blood transfusions, and quality of life.ResultsAs of May 3, 2011, CORONARY has recruited >3,884 patients from 79 centers in 19 countries. Currently, patient's mean age is 67.6 years, 80.7% are men, 47.0% have a history of diabetes, 51.4% have a history of smoking, and 34.4% had a previous MI. In addition, 20.9% of patients have a left main disease, and 96.6% have double or triple vessel disease.ConclusionsCORONARY is the largest trial yet conducted comparing off-pump CABG to on-pump CABG. Its results will lead to a better understanding of the safety and efficacy of off-pump CABG.Copyright © 2012 Mosby, Inc. All rights reserved.

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