• J. Thorac. Cardiovasc. Surg. · Nov 2014

    Review Meta Analysis

    Worse long-term survival after off-pump than on-pump coronary artery bypass grafting.

    • Hisato Takagi, Takuya Umemoto, and All-Literature Investigation of Cardiovascular Evidence (ALICE) Group.
    • Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan. Electronic address: kfgth973@ybb.ne.jp.
    • J. Thorac. Cardiovasc. Surg.. 2014 Nov 1;148(5):1820-9.

    ObjectiveTo determine whether off-pump coronary artery bypass grafting (CABG) is associated with worse long-term survival compared with on-pump CABG. We performed a meta-analysis of adjusted observational studies and randomized controlled trials.MethodsMEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through March 2014. Eligible studies were randomized controlled trials and adjusted observational studies (in which appropriate statistical methods adjusting for confounders had been used) of off-pump versus on-pump CABG that had reported long-term (≥5-year) all-cause mortality as an outcome.ResultsOf 478 potentially relevant studies screened initially, 5 randomized trials and 17 observational studies, enrolling a total of 104,306 patients, were identified and included. A pooled analysis of all 22 studies demonstrated a statistically significant 7% increase in long-term all-cause mortality with off-pump relative to on-pump CABG (hazard ratio, 1.07; 95% confidence interval, 1.03-1.11; P=.0003). Although a pooled analysis of 5 randomized trials (1486 patients) demonstrated a statistically nonsignificant 14% increase in mortality with off-pump relative to on-pump CABG (hazard ratio, 1.14; 95% confidence interval, 0.84-1.56; P=.39), another pooled analysis of 17 observational studies (102,820 patients) demonstrated a statistically significant 7% increase in mortality with off-pump relative to on-pump CABG (hazard ratio, 1.07; 95% confidence interval, 1.03-1.11; P=.0004).ConclusionsA meta-analysis of 22 studies, enrolling a total of >100,000 patients, showed that off-pump CABG is likely associated with worse long-term (≥5-year) survival compared with on-pump CABG.Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

      Pubmed     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…