Meta-analysis on the effect of off-pump coronary bypass surgery.
OBJECTIVE
To assess the effect of conventional coronary artery bypass surgery (CABG) compared to the off-pump procedure (OPCAB).


METHODS
Based on randomised trials found in PubMed and Science Citation Index, an overall odds ratio and 95% confidence interval was calculated for the combined endpoint of mortality, stroke and myocardial infarction.


RESULTS
The 18 randomised trials included 1584 patients (783 OPCAB, 801 CABG). The odds ratio was 0.73 (95% CI=0.26; 2.04) at 2-week post-surgery, 0.75 (0.39; 1.42) at 1-month post-surgery, 0.55 (0.28; 1.08) at 3-month post-surgery, and 0.66 (0.38; 1.15) at 1-year post-surgery.


CONCLUSIONS
The outcome of this meta-analysis shows favourable results for OPCAB for the combined endpoint of mortality, stroke and myocardial infarction at short and long term follow-up. However, none of the risk reductions reach statistical significance at the conventional level. Based on our results OPCAB appears to be equivalent to CABG.
van der Heijden
Geert J M G
GJ
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. g.vanderheijden@umcutrecht.nl
Nathoe
Hendrik M
HM
Jansen
Erik W L
EW
Grobbee
Diederick E
DE
D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome