Diegeler, Anno and Boergermann, Jochen and Kappert, Utz and Breuer, Martin and Boening, Andreas and Ursulescu, Adrian and Rastan, Ardawan and Holzhey, David and Treede, Hendrik and Riess, Friedrich-Christian and Veeckmann, Philippe and Asfoor, Amjad and Reents, Wilko and Zacher, Michael and Hilker, Michael (2013) Off-Pump versus On-Pump Coronary-Artery Bypass Grafting in Elderly Patients. NEW ENGLAND JOURNAL OF MEDICINE, 368 (13). pp. 1189-1198. ISSN 0028-4793, 1533-4406
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND The benefits of coronary-artery bypass grafting (CABG) without cardiopulmonary bypass in the elderly are still undetermined. METHODS We randomly assigned patients 75 years of age or older who were scheduled for elective first-time CABG to undergo the procedure either without cardiopulmonary bypass (off-pump CABG) or with it (on-pump CABG). The primary end point was a composite of death, stroke, myocardial infarction, repeat revascularization, or new renal-replacement therapy at 30 days and at 12 months after surgery. RESULTS A total of 2539 patients underwent randomization. At 30 days after surgery, there was no significant difference between patients who underwent off-pump surgery and those who underwent on-pump surgery in terms of the composite outcome (7.8% vs. 8.2%; odds ratio, 0.95; 95% confidence interval [CI], 0.71 to 1.28; P = 0.74) or four of the components (death, stroke, myocardial infarction, or new renal-replacement therapy). Repeat revascularization occurred more frequently after off-pump CABG than after on-pump CABG (1.3% vs. 0.4%; odds ratio, 2.42; 95% CI, 1.03 to 5.72; P = 0.04). At 12 months, there was no significant between-group difference in the composite end point (13.1% vs. 14.0%; hazard ratio, 0.93; 95% CI, 0.76 to 1.16; P = 0.48) or in any of the individual components. Similar results were obtained in a per-protocol analysis that excluded the 177 patients who crossed over from the assigned treatment to the other treatment. CONCLUSIONS In patients 75 years of age or older, there was no significant difference between on-pump and off-pump CABG with regard to the composite outcome of death, stroke, myocardial infarction, repeat revascularization, or new renal-replacement therapy within 30 days and within 12 months after surgery. (Funded by Maquet; GOPCABE ClinicalTrials.gov number, NCT00719667.)
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RISK PATIENTS; CARDIOPULMONARY BYPASS; LOGISTIC EUROSCORE; SURGERY; OUTCOMES; TRIAL; PATENCY; REVASCULARIZATION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Apr 2020 05:17 |
| Last Modified: | 23 Apr 2020 05:17 |
| URI: | https://pred.uni-regensburg.de/id/eprint/16966 |
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