title: On-pump versus off-pump coronary artery bypass surgery in patients older than 60 years: five-year follow-up of MASS III trial.
abstract: BACKGROUND
  We aim to evaluate in-hospital events and long-term clinical outcomes in patients over 60 years of age with stable coronary artery disease and preserved left ventricular ejection fraction undergoing off-pump or on-pump coronary artery bypass grafting.
  
  
  METHODS
  The MASS III was a single-center randomized trial that evaluate 308 patients with stable coronary artery disease and preserved ventricular function assigned for: 155 to off-pump and 153 to on-pump CABG. Of this, 176 (58.3%) patients were 60 years or older at the time of randomization (90 of-pump and 86 on-pump). The primary short-term end point was a composite of myocardial infarction, stroke, and overall mortality occurring within 30 days after surgery or before discharge, whichever was later. The primary long-term end point was death from any cause within 5 years, non-fatal myocardial infarction between 30 days and 5 years, or additional revascularization between 30 days and 5 years.
  
  
  RESULTS
  On-pump CABG had a higher incidence of 30-day composite outcome than off-pump CABG (15,1% and 5.6%, respectively; P = 0.036). However, after the multivariate analysis, this association lost statistical significance, P = 0.05. After 5-year follow-up, there were no significant differences between both strategies of CABG in the composite end points 16.7% and 15.1%; Hazard Ratio 1.07; CI 0.41 - 1.82; P = 0.71, for off-pump and on-pump CABG respectively.
  
  
  CONCLUSIONS
  On-pump and off-pump CABG achieved similar results of combined events at short-term and 5-year follow-up.
  
  
  BACKGROUND
  Clinical Trial Registration Information-URL: http://www.controlled-trials.com.
  
  
  BACKGROUND
  ISRCTN59539154.
authors.forename: Rodrigo Morel
authors.initials: RM
authors.lastname: Vieira de Melo
authors.affiliation: Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. mass@incor.usp.br.
authors.forename: Whady
authors.initials: W
authors.lastname: Hueb
authors.forename: Paulo Cury
authors.initials: PC
authors.lastname: Rezende
authors.forename: Eduardo Gomes
authors.initials: EG
authors.lastname: Lima
authors.forename: Alexandre Ciappina
authors.initials: AC
authors.lastname: Hueb
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
authors.forename: Roberto
authors.initials: R
authors.lastname: Kalil Filho
mesh_terms: D000367:Age Factors; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000401:mortality; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged
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