Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery

Matthew L. Williams, Lawrence H. Muhlbaier, Jacob N. Schroder, Jonathan A. Hata, Eric D. Peterson, Peter K. Smith, Kevin P. Landolfo, Robert H. Messier, R. Duane Davis, Carmelo A. Milano

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background - Surgeons have adopted off-pump coronary artery bypass grafting (OPCAB) in an effort to reduce the morbidity of surgical revascularization. However, long-term outcome of OPCAB compared with conventional coronary artery bypass grafting (CABG) remains poorly defined. Methods and Results - Using logistic regression analysis and proportional hazards modeling, short-term and long-term outcomes (perioperative mortality and complications, risk-adjusted survival, and survival/freedom from revascularization) were investigated for patients who underwent OPCAB (641 patients) and CABG-cardiopulmonary bypass (5026 patients) from 1998 to 2003 at our institution. For these variables, follow-up was 98% complete. OPCAB patients were less likely to receive transfusion (odds ratio for OPCAB, 0.80; P=0.037), and there were trends toward improvement in other short-term outcomes compared with CABG-cardiopulmonary bypass. Long-term outcomes analysis demonstrated no difference in survival, but OPCAB patients were more likely to require repeat revascularization (OPCAB hazard ratio, 1.29; P=0.020). Conclusions - OPCAB patients were less likely to receive transfusion during their hospitalization for surgery but had higher risk for revascularization in follow-up. These results highlight the need for a large randomized, controlled trial to compare these 2 techniques.

Original languageEnglish (US)
JournalCirculation
Volume112
Issue number9 SUPPL.
DOIs
StatePublished - Aug 30 2005
Externally publishedYes

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Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
Cardiopulmonary Bypass
Survival
Hospitalization
Randomized Controlled Trials
Logistic Models
Odds Ratio
Regression Analysis

Keywords

  • CABG surgery
  • Long-term
  • Off-pump surgery
  • OPCAB

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Williams, M. L., Muhlbaier, L. H., Schroder, J. N., Hata, J. A., Peterson, E. D., Smith, P. K., ... Milano, C. A. (2005). Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery. Circulation, 112(9 SUPPL.). https://doi.org/10.1161/CIRCULATIONAHA.104.526012

Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery. / Williams, Matthew L.; Muhlbaier, Lawrence H.; Schroder, Jacob N.; Hata, Jonathan A.; Peterson, Eric D.; Smith, Peter K.; Landolfo, Kevin P.; Messier, Robert H.; Davis, R. Duane; Milano, Carmelo A.

In: Circulation, Vol. 112, No. 9 SUPPL., 30.08.2005.

Research output: Contribution to journalArticle

Williams, ML, Muhlbaier, LH, Schroder, JN, Hata, JA, Peterson, ED, Smith, PK, Landolfo, KP, Messier, RH, Davis, RD & Milano, CA 2005, 'Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery', Circulation, vol. 112, no. 9 SUPPL.. https://doi.org/10.1161/CIRCULATIONAHA.104.526012
Williams ML, Muhlbaier LH, Schroder JN, Hata JA, Peterson ED, Smith PK et al. Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery. Circulation. 2005 Aug 30;112(9 SUPPL.). https://doi.org/10.1161/CIRCULATIONAHA.104.526012
Williams, Matthew L. ; Muhlbaier, Lawrence H. ; Schroder, Jacob N. ; Hata, Jonathan A. ; Peterson, Eric D. ; Smith, Peter K. ; Landolfo, Kevin P. ; Messier, Robert H. ; Davis, R. Duane ; Milano, Carmelo A. / Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery. In: Circulation. 2005 ; Vol. 112, No. 9 SUPPL.
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AB - Background - Surgeons have adopted off-pump coronary artery bypass grafting (OPCAB) in an effort to reduce the morbidity of surgical revascularization. However, long-term outcome of OPCAB compared with conventional coronary artery bypass grafting (CABG) remains poorly defined. Methods and Results - Using logistic regression analysis and proportional hazards modeling, short-term and long-term outcomes (perioperative mortality and complications, risk-adjusted survival, and survival/freedom from revascularization) were investigated for patients who underwent OPCAB (641 patients) and CABG-cardiopulmonary bypass (5026 patients) from 1998 to 2003 at our institution. For these variables, follow-up was 98% complete. OPCAB patients were less likely to receive transfusion (odds ratio for OPCAB, 0.80; P=0.037), and there were trends toward improvement in other short-term outcomes compared with CABG-cardiopulmonary bypass. Long-term outcomes analysis demonstrated no difference in survival, but OPCAB patients were more likely to require repeat revascularization (OPCAB hazard ratio, 1.29; P=0.020). Conclusions - OPCAB patients were less likely to receive transfusion during their hospitalization for surgery but had higher risk for revascularization in follow-up. These results highlight the need for a large randomized, controlled trial to compare these 2 techniques.

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