title: The cost implications of off-pump versus on-pump coronary artery bypass graft surgery at one year.
abstract: BACKGROUND
  The purpose of this study was to determine the cost implications of the Coronary Artery Bypass Graft Off or On Pump Revascularization Study (CORONARY) at 1 year.
  
  
  METHODS
  Country-specific healthcare costs were obtained from public databases or local experts from each country in the CORONARY trial. Purchasing power parities were applied to these costs of consumed healthcare resources. Analyses of subgroups included in the CORONARY clinical trial were also conducted. Costs are reported in US dollars.
  
  
  RESULTS
  After 1 year, the total cost per patient in the off-pump coronary artery bypass graft surgery (CABG) arm was $9,650 ($9,216 to $10,285) compared with $9,583 ($9,239 to $9,988) for the on-pump CABG arm; that resulted in a nonsignificant increase of $68 (-$575 to $710). Similar findings were noted for various subgroups. There were also no differences due to late conversions.
  
  
  CONCLUSIONS
  The CORONARY trial demonstrated that off-pump CABG was clinically as safe and effective as on-pump CABG with no difference in costs. Thus, the decision as to which method to choose is free from costs considerations and should be based on patient preference and surgeon expertise (Coronary Artery Bypass Graft [CABG] Off or On Pump Revascularization Study [CORONARY]; clinicaltrials.gov NCT00463294).
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; CADENCE Research Group, Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. Electronic address: lamya@mcmaster.ca.
authors.forename: Andre
authors.initials: A
authors.lastname: Lamy
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; CADENCE Research Group, Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Wesley
authors.initials: W
authors.lastname: Tong
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: P J
authors.initials: PJ
authors.lastname: Devereaux
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Peggy
authors.initials: P
authors.lastname: Gao
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Center for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.affiliation: All India Institute of Medical Sciences, New Delhi, India; Center for Chronic Disease Control, New Delhi, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Singh
authors.affiliation: Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Taggart
authors.affiliation: Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Zbyek
authors.initials: Z
authors.lastname: Straka
authors.affiliation: Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Ahmet R
authors.initials: AR
authors.lastname: Akar
authors.affiliation: Unidade de Terapia Intensiva, Hospital do Coração, São Paulo, Brazil.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Piegas
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Yongning
authors.initials: Y
authors.lastname: Ou
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000191:economics*; D047549:Coronary Artery Bypass, Off-Pump / Q000191:economics; D003324:Coronary Artery Disease / Q000191:economics / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors