Abstract
Objectives The debate regarding the advantages and limitations of off-pump versus on-pump coronary artery bypass grafting (CABG) has yet to be resolved. This study was designed to compare the impact of surgical technique on long-term mortality and subsequent revascularization. Methods The Predicting Long-Term Outcomes After Isolated Coronary Artery Bypass Surgery (PRIORITY) project was designed to evaluate the long-term outcomes of 2 large, prospective multicenter cohort studies on CABG conducted in Italy between 2002 and 2004 and in 2007 and 2008. Clinical data on isolated CABG were compiled from 2 administrative databases. Results The study population consisted of 11,021 patients who underwent isolated CABG (27.2% off-pump CABG). Surgical strategy did not affect in-hospital mortality. Multivariate logistic regression demonstrated that on-pump CABG was the only factor that protected from in-hospital percutaneous coronary intervention after surgery (odds ratio, 0.61). Although unadjusted long-term survival was significantly worse for off-pump CABG, adjustment did not confirm off-pump CABG as a risk factor for mortality (hazard ratio, 0.96; 95% confidence interval, 0.87-1.06). The on-pump CABG group had a significantly lower hospitalization for subsequent percutaneous coronary intervention, a finding confirmed even with adjustment for confounding factors (hazard ratio, 0.70; 95% confidence interval, 0.62-0.80; P
| Original language | English |
|---|---|
| Pages (from-to) | 902-909 |
| Number of pages | 8 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 150 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Oct 1 2015 |
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Keywords
- follow-up studies
- revascularization
- risk factors
- surgery
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
- Medicine(all)
Cite this
Impact of off-pump coronary artery bypass grafting on long-term percutaneous coronary interventions. / Barili, Fabio; Rosato, Stefano; D'Errigo, Paola; Parolari, Alessandro; Fusco, Danilo; Perucci, Carlo Alberto; Menicanti, Lorenzo; Seccareccia, Fulvia.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 150, No. 4, 01.10.2015, p. 902-909.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of off-pump coronary artery bypass grafting on long-term percutaneous coronary interventions
AU - Barili, Fabio
AU - Rosato, Stefano
AU - D'Errigo, Paola
AU - Parolari, Alessandro
AU - Fusco, Danilo
AU - Perucci, Carlo Alberto
AU - Menicanti, Lorenzo
AU - Seccareccia, Fulvia
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Objectives The debate regarding the advantages and limitations of off-pump versus on-pump coronary artery bypass grafting (CABG) has yet to be resolved. This study was designed to compare the impact of surgical technique on long-term mortality and subsequent revascularization. Methods The Predicting Long-Term Outcomes After Isolated Coronary Artery Bypass Surgery (PRIORITY) project was designed to evaluate the long-term outcomes of 2 large, prospective multicenter cohort studies on CABG conducted in Italy between 2002 and 2004 and in 2007 and 2008. Clinical data on isolated CABG were compiled from 2 administrative databases. Results The study population consisted of 11,021 patients who underwent isolated CABG (27.2% off-pump CABG). Surgical strategy did not affect in-hospital mortality. Multivariate logistic regression demonstrated that on-pump CABG was the only factor that protected from in-hospital percutaneous coronary intervention after surgery (odds ratio, 0.61). Although unadjusted long-term survival was significantly worse for off-pump CABG, adjustment did not confirm off-pump CABG as a risk factor for mortality (hazard ratio, 0.96; 95% confidence interval, 0.87-1.06). The on-pump CABG group had a significantly lower hospitalization for subsequent percutaneous coronary intervention, a finding confirmed even with adjustment for confounding factors (hazard ratio, 0.70; 95% confidence interval, 0.62-0.80; P
AB - Objectives The debate regarding the advantages and limitations of off-pump versus on-pump coronary artery bypass grafting (CABG) has yet to be resolved. This study was designed to compare the impact of surgical technique on long-term mortality and subsequent revascularization. Methods The Predicting Long-Term Outcomes After Isolated Coronary Artery Bypass Surgery (PRIORITY) project was designed to evaluate the long-term outcomes of 2 large, prospective multicenter cohort studies on CABG conducted in Italy between 2002 and 2004 and in 2007 and 2008. Clinical data on isolated CABG were compiled from 2 administrative databases. Results The study population consisted of 11,021 patients who underwent isolated CABG (27.2% off-pump CABG). Surgical strategy did not affect in-hospital mortality. Multivariate logistic regression demonstrated that on-pump CABG was the only factor that protected from in-hospital percutaneous coronary intervention after surgery (odds ratio, 0.61). Although unadjusted long-term survival was significantly worse for off-pump CABG, adjustment did not confirm off-pump CABG as a risk factor for mortality (hazard ratio, 0.96; 95% confidence interval, 0.87-1.06). The on-pump CABG group had a significantly lower hospitalization for subsequent percutaneous coronary intervention, a finding confirmed even with adjustment for confounding factors (hazard ratio, 0.70; 95% confidence interval, 0.62-0.80; P
KW - follow-up studies
KW - revascularization
KW - risk factors
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=84942817751&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942817751&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2015.07.018
DO - 10.1016/j.jtcvs.2015.07.018
M3 - Article
C2 - 26277472
AN - SCOPUS:84942817751
VL - 150
SP - 902
EP - 909
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 4
ER -