title: Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year.
abstract: BACKGROUND
  Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outcomes at 1 year.
  
  
  METHODS
  We enrolled 4752 patients with coronary artery disease who were scheduled to undergo CABG and randomly assigned them to undergo the procedure off-pump or on-pump. Patients were enrolled at 79 centers in 19 countries. We assessed quality of life and cognitive function at discharge, at 30 days, and at 1 year and clinical outcomes at 1 year.
  
  
  RESULTS
  At 1 year, there was no significant difference in the rate of the primary composite outcome between off-pump and on-pump CABG (12.1% and 13.3%, respectively; hazard ratio with off-pump CABG, 0.91; 95% confidence interval [CI], 0.77 to 1.07; P=0.24). The rate of the primary outcome was also similar in the two groups in the period between 31 days and 1 year (hazard ratio, 0.79; 95% CI, 0.55 to 1.13; P=0.19). The rate of repeat coronary revascularization at 1 year was 1.4% in the off-pump group and 0.8% in the on-pump group (hazard ratio, 1.66; 95% CI, 0.95 to 2.89; P=0.07). There were no significant differences between the two groups at 1 year in measures of quality of life or neurocognitive function.
  
  
  CONCLUSIONS
  At 1 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. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294.).
authors.affiliation: The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada. lamya@mcmaster.ca
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authors.initials: A
authors.lastname: Lamy
authors.forename: P J
authors.initials: PJ
authors.lastname: Devereaux
authors.forename: Dorairaj
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authors.lastname: Prabhakaran
authors.forename: David P
authors.initials: DP
authors.lastname: Taggart
authors.forename: Shengshou
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authors.lastname: Hu
authors.forename: Ernesto
authors.initials: E
authors.lastname: Paolasso
authors.forename: Zbynek
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authors.lastname: Straka
authors.forename: Leopoldo S
authors.initials: LS
authors.lastname: Piegas
authors.forename: Ahmet Ruchan
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authors.lastname: Akar
authors.forename: Anil R
authors.initials: AR
authors.lastname: Jain
authors.forename: Nicolas
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authors.lastname: Noiseux
authors.forename: Chandrasekar
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authors.lastname: Padmanabhan
authors.forename: Juan-Carlos
authors.initials: JC
authors.lastname: Bahamondes
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Novick
authors.forename: Prashant
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authors.lastname: Vaijyanath
authors.forename: Sukesh Kumar
authors.initials: SK
authors.lastname: Reddy
authors.forename: Liang
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authors.lastname: Tao
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Olavegogeascoechea
authors.forename: Balram
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authors.lastname: Airan
authors.forename: Toomas-Andres
authors.initials: TA
authors.lastname: Sulling
authors.forename: Richard P
authors.initials: RP
authors.lastname: Whitlock
authors.forename: Yongning
authors.initials: Y
authors.lastname: Ou
authors.forename: Janice
authors.initials: J
authors.lastname: Pogue
authors.forename: Susan
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authors.forename: Salim
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authors.lastname: Yusuf
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D011788:Quality of Life; D051437:Renal Insufficiency / Q000209:etiology; D012086:Reoperation / Q000706:statistics & numerical data; D020521:Stroke / Q000209:etiology