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On-pump versus off-pump coronary artery bypass surgery in patients older than 60 years: five-year follow-up of MASS III trial.
MedLine Citation:
PMID:  25096030     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We 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.
METHODS: The 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.
RESULTS: On-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.
CONCLUSIONS: On-pump and off-pump CABG achieved similar results of combined events at short-term and 5-year follow-up.Trial registration: Clinical Trial Registration Information--URL: http://www.controlled-trials.com. Registration number: ISRCTN59539154.
Authors:
Rodrigo Morel Vieira de Melo; Whady Hueb; Paulo Cury Rezende; Eduardo Gomes Lima; Alexandre Ciappina Hueb; José Antonio Ramires; Roberto Kalil Filho
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-5
Journal Detail:
Title:  Journal of cardiothoracic surgery     Volume:  9     ISSN:  1749-8090     ISO Abbreviation:  J Cardiothorac Surg     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101265113     Medline TA:  J Cardiothorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  136     Citation Subset:  -    
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