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ACC: No Difference in Outcomes With Off-Pump, On-Pump CABG

Two studies show no difference in outcomes for elderly, patients with CAD at 30 days, one year

ACC: No Difference in Outcomes With Off-Pump, On-Pump CABG

MONDAY, March 11 (HealthDay News) -- For patients scheduled for coronary artery bypass grafting (CABG), outcomes are not significantly different for those undergoing the procedure without cardiopulmonary bypass (off-pump) or with it (on-pump), according to two studies published online March 11 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 9 to 11 in San Francisco.

Anno Diegeler, M.D., Ph.D., from the Herz- und Gefäss-Klinik Bad Neustadt in Germany, and colleagues randomized 2,539 patients aged 75 years or older who were scheduled for elective CABG to undergo the procedure off-pump or on-pump. The researchers found that at 30 days and 12 months there was no significant difference between the groups in the composite outcome or four of the components (death, stroke, myocardial infarction, or new renal-replacement therapy). Repeat revascularization occurred more frequently with off-pump CABG (1.3 versus 0.4 percent; P = 0.04).

André Lamy, M.D., from McMaster University in Hamilton, Canada, and colleagues randomized 4,752 patients with coronary artery disease scheduled to undergo CABG enrolled at 79 centers in 19 countries to undergo the procedure on-pump or off-pump. The researchers found that the rate of the primary composite outcome was not significantly different at one year with off-pump versus on-pump CABG (12.1 versus 13.3 percent; P = 0.24). At one year, the rate of repeat coronary revascularization was 1.4 versus 0.8 percent in the off-pump versus on-pump groups (P = 0.07).

"At one year after CABG, there was no significant difference between off-pump and on-pump CABG with respect to the primary composite outcome, the rate of repeat coronary revascularization, quality of life, or neurocognitive function," Lamy and colleagues write.

The Diegeler study was supported by Maquet.

Abstract - Diegeler
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Abstract - Lamy
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