Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis
The aim of this study was to analyze if off-pump coronary artery bypass surgery (CABG) is associated with better treatment outcomes in elderly patients (>70 years of age) than on-pump CABG, using meta-analysis. Medline, PubMed, Cochrane and Google Scholar databases were searched until September 1...
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| Format: | Article |
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Associação Brasileira de Divulgação Científica
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| Series: | Brazilian Journal of Medical and Biological Research |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2017000300704&lng=en&tlng=en |
| _version_ | 1828766116810326016 |
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| author | Z.G. Zhu W. Xiong J.L. Ding J. Chen Y. Li J.L. Zhou J.J. Xu |
| author_facet | Z.G. Zhu W. Xiong J.L. Ding J. Chen Y. Li J.L. Zhou J.J. Xu |
| author_sort | Z.G. Zhu |
| collection | DOAJ |
| description | The aim of this study was to analyze if off-pump coronary artery bypass surgery (CABG) is associated with better treatment outcomes in elderly patients (>70 years of age) than on-pump CABG, using meta-analysis. Medline, PubMed, Cochrane and Google Scholar databases were searched until September 13, 2016. Sensitivity and quality assessment were performed. Twenty-two studies, three randomized control trials (RCTs) and 20 non-RCTs were included with 24,127 patients. The risk of death associated with on-pump or off-pump CABG in the RCTs were similar (pooled OR=0.945, 95%CI=0.652 to 1.371, P=0.766). However, in the non-RCTs, mortality risk was lower in patients treated with off-pump CABG than on-pump CABG (pooled OR=0.631, 95%CI=0.587 to 0.944, P=0.003). No differences were observed between the two treatment groups in terms of the occurrence of 30-day post-operative stroke or myocardial infarction (P≥0.147). In the non-RCTs, off-pump CABG treatment was associated with a shorter length of hospital stay (pooled standardized difference in means=-0.401, 95%CI=-0.621 to -0.181, P≤0.001). The meta-analysis with pooled data from non-RCTs, but not RCTs, found that mortality was lower with off-pump compared with on-pump CABG, and suggested that there may be some benefit of off-pump CABG compared with on-pump CABG in the risk of mortality and length of hospital stay. |
| first_indexed | 2024-12-11T06:59:29Z |
| format | Article |
| id | doaj.art-dcc4368bd412424e84752efb35ee16aa |
| institution | Directory Open Access Journal |
| issn | 1414-431X |
| language | English |
| last_indexed | 2024-12-11T06:59:29Z |
| publisher | Associação Brasileira de Divulgação Científica |
| record_format | Article |
| series | Brazilian Journal of Medical and Biological Research |
| spelling | doaj.art-dcc4368bd412424e84752efb35ee16aa2022-12-22T01:16:39ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research1414-431X50310.1590/1414-431x20165711S0100-879X2017000300704Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysisZ.G. ZhuW. XiongJ.L. DingJ. ChenY. LiJ.L. ZhouJ.J. XuThe aim of this study was to analyze if off-pump coronary artery bypass surgery (CABG) is associated with better treatment outcomes in elderly patients (>70 years of age) than on-pump CABG, using meta-analysis. Medline, PubMed, Cochrane and Google Scholar databases were searched until September 13, 2016. Sensitivity and quality assessment were performed. Twenty-two studies, three randomized control trials (RCTs) and 20 non-RCTs were included with 24,127 patients. The risk of death associated with on-pump or off-pump CABG in the RCTs were similar (pooled OR=0.945, 95%CI=0.652 to 1.371, P=0.766). However, in the non-RCTs, mortality risk was lower in patients treated with off-pump CABG than on-pump CABG (pooled OR=0.631, 95%CI=0.587 to 0.944, P=0.003). No differences were observed between the two treatment groups in terms of the occurrence of 30-day post-operative stroke or myocardial infarction (P≥0.147). In the non-RCTs, off-pump CABG treatment was associated with a shorter length of hospital stay (pooled standardized difference in means=-0.401, 95%CI=-0.621 to -0.181, P≤0.001). The meta-analysis with pooled data from non-RCTs, but not RCTs, found that mortality was lower with off-pump compared with on-pump CABG, and suggested that there may be some benefit of off-pump CABG compared with on-pump CABG in the risk of mortality and length of hospital stay.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2017000300704&lng=en&tlng=enCoronary artery bypass grafting/CABGOff-pumpOn-pumpElderlyMeta-analysis |
| spellingShingle | Z.G. Zhu W. Xiong J.L. Ding J. Chen Y. Li J.L. Zhou J.J. Xu Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis Brazilian Journal of Medical and Biological Research Coronary artery bypass grafting/CABG Off-pump On-pump Elderly Meta-analysis |
| title | Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis |
| title_full | Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis |
| title_fullStr | Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis |
| title_full_unstemmed | Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis |
| title_short | Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis |
| title_sort | comparison of outcomes between off pump versus on pump coronary artery bypass surgery in elderly patients a meta analysis |
| topic | Coronary artery bypass grafting/CABG Off-pump On-pump Elderly Meta-analysis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2017000300704&lng=en&tlng=en |
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