Outcomes in off-pump vs. on-pump coronary artery bypass grafting stratified by pre-operative risk profile: an assessment using propensity score.
نویسندگان
چکیده
AIMS To assess the benefit of off-pump coronary surgery stratified by the pre-operative risk profile. METHODS AND RESULTS Prospective and multicentric cohort study. All consecutive patients undergoing a first coronary bypass procedure between November 2001 and November 2003 were potentially eligible. Pre-operative EuroSCORE and in-hospital outcomes were prospectively collected using strictly standardized criteria. To ensure optimal adjustment, a propensity score was constructed using clinically relevant variables and incorporating individual centres. Of 1602 patients who underwent a first coronary bypass, EuroSCORE could be calculated in 1585: 787 were of moderate/high pre-operative risk profile (EuroSCORE > 3), of which 347 underwent off-pump procedures, and 798 were of low pre-operative risk profile (EuroSCORE < or = 3), of which 349 underwent off-pump procedures. After risk adjusting for propensity score, off-pump patients had less major events (post-operative death, myocardial infarction, and need for reoperation). This benefit was higher in the low-risk stratum (OR ranged between 0.27 and 0.4; P = 0.02-0.07) than in the high-risk stratum (OR between 0.4 and 0.7; P, not significant). CONCLUSION In real-life conditions, off-pump coronary surgery may be more effective than on-pump surgery. In contrast with previous reports, our results suggest that this benefit may be higher in patients with low pre-operative risk.
منابع مشابه
On-pump versus off-pump coronary artery bypass surgery in high-risk patients.
This study aimed to evaluate on-pump versus off-pump coronary artery bypass grafting (CABG) in patients with a high-risk operative profile.The pre-, intra- and post-operative data of high-risk patients with additive European system for cardiac operative risk evaluation (additive Euro-SCORE) over 6 undergoing isolated CABG from January 2008 to December 2011 in this center were investigated and r...
متن کاملA Propensity Score Analysis of Renal Dysfunction in Patients after On-Pump and Off-Pump Coronary Artery Bypass Surgery
INTRODUCTION- Cardiovascular disease has emerged as a major health burden worldwide with coronary artery disease [CAD] causing highest mortality and morbidity. Coronary revascularization is the preferred treatment for patients with multivessel CAD. Based on the application of cardiopulmonary bypass [CPB], Coronary revascularization can be on-pump [OPCAB] or off-pump [CABG].The CPB is known to h...
متن کاملn-Pump Versus Off-Pump Coronary Artery ypass Grafting in Diabetic Patients: A Propensity core Analysis
Background. Diabetic patients are recognized as being at high risk for adverse outcomes after coronary artery bypass grafting. We evaluated our outcomes in diabetic patients to compare the effect of off-pump with on-pump coronary revascularization. consecutive diabetic patients underwent isolated coronary artery bypass grafting. A total of 186 (19.6%) of these patients had off-pump coronary pro...
متن کاملAvoidance of Dialysis in an End-Stage Renal Disease Patient Status-post Off-pump Coronary Artery Bypass Grafting
Certain benefits are clearly associated with the use of off-pump coronary artery bypass grafting (CABG) as compared with the on-pump CABG. The superiority is more evident in patients with multiple co morbidities including renal failure.We reviewed the medical records of a 67-year-old male with a past medical history that was significant for multiple cardiovascular diseases and new-onset end-sta...
متن کاملOff-Pump Versus On-Pump Coronary Artery Bypass Graft Surgery, prospective cohort study
Introduction: Coronary artery bypass grafting is a surgical operation that bypasses atherosclerotic coronary vessels and restores blood flow to the ischemic zone of hearts. And two different conventional methods are ON-pump CABG, and Off-pump CABG. Altogether, the efficacy and safety of these two types of surgical procedures are still under debate. In this study, we aim to com...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- European heart journal
دوره 27 20 شماره
صفحات -
تاریخ انتشار 2006