• Rodrigo Morel Vieira de Melo, Whady Hueb, Paulo Cury Rezende, Eduardo Gomes Lima, Alexandre Ciappina Hueb, José Antonio Franchini Ramires, and Roberto Kalil Filho.
• Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. mass@incor.usp.br.
• J Cardiothorac Surg. 2014 Jan 1;9:127.

BackgroundWe aim to evaluate in-hospital events and long-term clinical outcomes in patients over 60 years of age with stable coronary artery disease and preserved left ventricular ejection fraction undergoing off-pump or on-pump coronary artery bypass grafting.MethodsThe MASS III was a single-center randomized trial that evaluate 308 patients with stable coronary artery disease and preserved ventricular function assigned for: 155 to off-pump and 153 to on-pump CABG. Of this, 176 (58.3%) patients were 60 years or older at the time of randomization (90 of-pump and 86 on-pump). The primary short-term end point was a composite of myocardial infarction, stroke, and overall mortality occurring within 30 days after surgery or before discharge, whichever was later. The primary long-term end point was death from any cause within 5 years, non-fatal myocardial infarction between 30 days and 5 years, or additional revascularization between 30 days and 5 years.ResultsOn-pump CABG had a higher incidence of 30-day composite outcome than off-pump CABG (15,1% and 5.6%, respectively; P = 0.036). However, after the multivariate analysis, this association lost statistical significance, P = 0.05. After 5-year follow-up, there were no significant differences between both strategies of CABG in the composite end points 16.7% and 15.1%; Hazard Ratio 1.07; CI 0.41 - 1.82; P = 0.71, for off-pump and on-pump CABG respectively.ConclusionsOn-pump and off-pump CABG achieved similar results of combined events at short-term and 5-year follow-up.Trial RegistrationClinical Trial Registration Information-URL: http://www.controlled-trials.com.Registration NumberISRCTN59539154.

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