• J. Am. Coll. Cardiol. · Jun 2014

    Comparative Study Observational Study

    Long-term survival following coronary artery bypass grafting: off-pump versus on-pump strategies.

    • Joon Bum Kim, Sung-Cheol Yun, Jae Wong Lim, Soo Kyung Hwang, Sung-Ho Jung, Hyun Song, Cheol Hyun Chung, Jae Won Lee, and Suk Jung Choo.
    • Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
    • J. Am. Coll. Cardiol. 2014 Jun 3; 63 (21): 2280-8.

    ObjectivesThis study sought to compare long-term survival after off- and on-pump coronary artery bypass grafting (CABG).BackgroundAlthough several large-scale clinical trials have compared the surgical outcomes between off- and on-pump CABG, the long-term survival has not been compared between the 2 surgical strategies in a reasonably sized cohort.MethodsWe evaluated long-term survival data in 5,203 patients (age 62.9 ± 9.1 years, 1,340 females) who underwent elective isolated CABG (off-pump: n = 2,333; on-pump: n = 2,870) from 1989 through 2012. Vital statuses were validated using the Korean National Registry of Vital Statistics. Long-term survival was compared with the use of propensity scores and inverse probability weighting to adjust selection bias.ResultsPatients undergoing on-pump CABG had a higher number of distal anastomoses than those undergoing off-pump CABG (3.7 ± 1.2 vs. 3.0 ± 1.1; p < 0.001). Survival data were complete in 5,167 patients (99.3%), with a median follow-up duration of 6.4 years (interquartile range: 3.7 to 10.5 years; maximum 23.1 years). During follow-up, 1,181 patients (22.7%) died. After adjustment, both groups of patients showed a similar risk of death at 30 days (odds ratio: 0.70; 95% confidence interval [CI]: 0.35 to 1.40; p = 0.31) and up to 1 year (hazard ratio [HR]: 1.11; 95% CI: 0.74 to 1.65; p = 0.62). For overall mortality, however, patients undergoing off-pump CABG were at a significantly higher risk of death (HR: 1.43; 95% CI: 1.19 to 1.71; p < 0.0001) compared with those undergoing on-pump CABG. In subgroup analyses, on-pump CABG conferred survival benefits in most demographic, clinical, and anatomic subgroups compared with off-pump CABG.ConclusionsIn patients undergoing elective isolated CABG, on-pump strategy conferred a long-term survival advantage compared with off-pump strategy.Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.