TY - JOUR
T1 - Off-Pump Coronary Artery Bypass Reduces Cardiac Death in Patients with Peripheral Arteriopathy
AU - Bonacchi, M.
AU - Howe, R.
AU - Micali, L.R.
AU - Weigel, D.
AU - Parise, O.
AU - Parise, G.
AU - Gelsomino, S.
N1 - Publisher Copyright:
© 2021 BioMed Central Ltd.. All rights reserved.
PY - 2021/10
Y1 - 2021/10
N2 - 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.
AB - 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.
KW - coronary revascularization
KW - peripheral artery disease
KW - peripheral ischemia
U2 - 10.1055/s-0041-1724036
DO - 10.1055/s-0041-1724036
M3 - Article
C2 - 33626589
SN - 0171-6425
VL - 69
SP - 614
EP - 620
JO - Thoracic and Cardiovascular Surgeon
JF - Thoracic and Cardiovascular Surgeon
IS - 07
ER -