Five-year outcomes similar for off-, on-pump CABG in CAD

(HealthDay)—Five-year outcomes are similar for patients with coronary artery disease who undergo off-pump or on-pump coronary artery bypass grafting (CABG), according to a study published online Oct. 23 in the New England Journal of Medicine to coincide with the annual Canadian Cardiovascular Congress, held from Oct. 22 to 25 in Montreal.

André Lamy, M.D., from McMaster University in Hamilton, Canada, and colleagues reported the five-year results of a randomized trial involving 4,752 patients with coronary artery disease who were randomized to undergo off-pump or on-pump CABG. They analyzed a composite outcome of death, stroke, myocardial infarction, renal failure, or repeat coronary revascularization (CABG or percutaneous coronary intervention).

The researchers found that the rate of the composite outcome did not differ significantly for the off-pump and on-pump groups (23.1 and 23.6 percent, respectively; hazard ratio with off-pump CABG, 0.98; 95 percent confidence interval, 0.87 to 1.10). There was also no significant difference in the rates of the separate components of the outcome. For the overall period of the trial, the secondary outcome of mean cost in U.S. dollars per patient also did not differ between the off-pump and on-pump group ($15,107 and $14,992, respectively).

"The rate of the composite outcome of death, stroke, myocardial infarction, renal failure, or repeat revascularization at five years of follow-up was similar among patients who underwent off-pump CABG and those who underwent on-pump CABG," the authors write.