Off-pump coronary artery bypass grafting improves short-term outcomes in high-risk patients compared with on-pump coronary artery bypass grafting: Meta-analysis

Mariusz Kowalewski, Wojciech Pawliszak, Pietro Giorgio Malvindi, Marek Pawel Bokszanski, Damian Perlinski, Giuseppe Maria Raffa, Magdalena Ewa Kowalkowska, Katarzyna Zaborowska, Eliano Pio Navarese, Michalina Kolodziejczak, Janusz Kowalewski, Giuseppe Tarelli, David Paul Taggart, Lech Anisimowicz

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives To assess the benefits and risks of off-pump coronary artery bypass (OPCAB) versus coronary artery bypass grafting (CABG) through a meta-analysis of randomized controlled trials (RCTs), and to investigate the relationship between outcomes and patient risk profile. Methods PubMed, Embase, the Cumulative Index of Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library, and major conference proceedings databases were searched for RCTs comparing OPCAB and CABG and reporting short-term (≤30 days) outcomes. Endpoints assessed were all-cause mortality, myocardial infarction (MI), and cerebral stroke. Results The meta-analysis included 100 studies, with a total of 19,192 subjects. There was no difference between the 2 techniques with respect to all-cause mortality and MI (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.71-1.09; P =.25; I2 = 0% and OR, 0.90; 95% CI, 0.77-1.05; P =.19; I2 = 0%, respectively). OPCAB was associated with a significant 28% reduction in the odds of cerebral stroke (OR, 0.72; 95% CI, 0.56-0.92; P =.009; I2 = 0%). A significant relationship between patient risk profile and benefits from OPCAB was found in terms of all-cause mortality (P

Original languageEnglish
Pages (from-to)60-77e58
JournalJournal of Thoracic and Cardiovascular Surgery
Volume151
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Keywords

  • cardiopulmonary bypass
  • cerebrovascular disorders
  • coronary disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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