Off-Pump Coronary Artery Bypass Reduces Cardiac Death in Patients with Peripheral Arteriopathy

M. Bonacchi, R. Howe, L.R. Micali, D. Weigel, O. Parise, G. Parise, S. Gelsomino*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective The aim of this study was to investigate whether the use of off-pump coronary artery bypass (OPCAB) may enhance early outcomes in subjects with peripheral artery disease (PAD) undergoing coronary artery bypass grafting (CABG).Methods We employed a propensity-score (PS) method to compare early postoperative results of OPCAB and on-pump CABG patients with associated PAD. The study population consisted of 1,961 patients: 284 in the OPCAB and 1,677 in the on-pump CABG group. The inverse probability of treatment weighting was used as PS method.Results The incidence of death (1.2% [95% confidence interval, CI: -0.9 to 3.3%], p =0.262), stroke (2.2% [95% CI: -1.4 to 5.7%], p =0.235), acute kidney disease (1.5% [95% CI: -3.8 to 6.8%], p =0.586), limb ischemia (3.2% [95% CI: -0.6 to 7.0%], p =0.315), and low output syndrome (1.2% [95% CI: -0.9 to 3.3%], p =0.262) did not differ between the two groups. On the other hand, the rate of cardiac death (1.2% [95% CI: -0.1 to 2.3%], p =0.038) was significantly higher in on-pump CABG group.Conclusions The OPCAB procedure considerably reduced the occurrence of cardiac death after coronary revascularization. This finding might suggest that the OPCAB procedure should be considered as the first option in patients with higher cardiovascular risk scores. Further research is warranted.
Original languageEnglish
Pages (from-to)614-620
Number of pages7
JournalThoracic and Cardiovascular Surgeon
Issue number07
Early online date24 Feb 2021
Publication statusPublished - Oct 2021


  • coronary revascularization
  • peripheral artery disease
  • peripheral ischemia

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