Year: 2013
Type: article
Study design: Clinical Trial
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.).
Source: New England Journal of Medicine
Authors: André Lamy, P.J. Devereaux, Dorairaj Prabhakaran, David P. Taggart, Shengshou Hu, Ernesto Paolasso, Zbynek Straka, Leopoldo S. Piegas, Ahmet Ruchan Akar, Anil R. Jain, Nicolas Noiseux, Chandrasekar Padmanabhan, Juan-Carlos Bahamondes, Richard J. Novick, Prashant Vaijyanath, Sukesh Kumar Reddy, Liang Tao, Pablo A. Olavegogeascoechea, Balram Airan, Toomas-Andres Sulling, Richard P. Whitlock, Yongning Ou, Janice Pogue, Susan Chrolavicius, Salim Yusuf
Institutions: Population Health Research Institute, Hamilton Health Sciences, McMaster University, University of Oxford, Fu Wai Hospital, Charles University, Instituto Dante Pazzanese de Cardiologia, Ankara University, Centre Hospitalier de l’Université de Montréal, G. Kuppuswamy Naidu Memorial Hospital, Hospital Doctor Hernán Henríquez Aravena, London Health Sciences Centre, Frontier Lifeline Hospital, MaxCure Hospitals, Wuhan Asia Heart Hospital, All India Institute of Medical Sciences, North Estonia Medical Centre
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2107706993