Document Detail


Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery.
MedLine Citation:
PMID:  16159847     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgeons have adopted off-pump coronary artery bypass grafting (OPCAB) in an effort to reduce the morbidity of surgical revascularization. However, long-term outcome of OPCAB compared with conventional coronary artery bypass grafting (CABG) remains poorly defined. METHODS AND RESULTS: Using logistic regression analysis and proportional hazards modeling, short-term and long-term outcomes (perioperative mortality and complications, risk-adjusted survival, and survival/freedom from revascularization) were investigated for patients who underwent OPCAB (641 patients) and CABG-cardiopulmonary bypass (5026 patients) from 1998 to 2003 at our institution. For these variables, follow-up was 98% complete. OPCAB patients were less likely to receive transfusion (odds ratio for OPCAB, 0.80; P=0.037), and there were trends toward improvement in other short-term outcomes compared with CABG-cardiopulmonary bypass. Long-term outcomes analysis demonstrated no difference in survival, but OPCAB patients were more likely to require repeat revascularization (OPCAB hazard ratio, 1.29; P=0.020). CONCLUSIONS: OPCAB patients were less likely to receive transfusion during their hospitalization for surgery but had higher risk for revascularization in follow-up. These results highlight the need for a large randomized, controlled trial to compare these 2 techniques.
Authors:
Matthew L Williams; Lawrence H Muhlbaier; Jacob N Schroder; Jonathan A Hata; Eric D Peterson; Peter K Smith; Kevin P Landolfo; Robert H Messier; R Duane Davis; Carmelo A Milano
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-14     Completed Date:  2006-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  I366-70     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27703, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass / statistics & numerical data*
Coronary Artery Bypass, Off-Pump / statistics & numerical data*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Life Tables
Logistic Models
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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