Off-Pump or On-Pump Coronary-Artery Bypass Grafting at 30 Days
| Autor: | André, Lamy, P J, Devereaux, Dorairaj, Prabhakaran, David P, Taggart, Shengshou, Hu, Ernesto, Paolasso, Zbynek, Straka, Leopoldo S, Piegas, Ahmet Ruchan, Akar, Anil R, Jain, Nicolas, Noiseux, Chandrasekar, Padmanabhan, Juan-Carlos, Bahamondes, Richard J, Novick, Prashant, Vaijyanath, Sukesh, Reddy, Liang, Tao, Pablo A, Olavegogeascoechea, Balram, Airan, Toomas-Andres, Sulling, Richard P, Whitlock, Yongning, Ou, Jennifer, Ng, Susan, Chrolavicius, Salim, Yusuf, R L, Tourville |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Bypass grafting medicine.medical_treatment Coronary Artery Bypass Off-Pump Myocardial Infarction Coronary Artery Disease Revascularization law.invention Postoperative Complications law Internal medicine medicine Cardiopulmonary bypass Humans Blood Transfusion Single-Blind Method Renal Insufficiency Myocardial infarction Coronary Artery Bypass Stroke Dialysis Aged business.industry Hazard ratio General Medicine Perioperative Middle Aged medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Relative risk Cardiology Female business Artery |
| Zdroj: | New England Journal of Medicine. 366:1489-1497 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejmoa1200388 |
| Popis: | BACKGROUND: The relative benefits and risks of performing coronary-artery bypass grafting (CABG) with a beating-heart technique (off-pump CABG), as compared with cardiopulmonary bypass (on-pump CABG), are not clearly established. METHODS: At 79 centers in 19 countries, we randomly assigned 4752 patients in whom CABG was planned to undergo the procedure off-pump or on-pump. The first coprimary outcome was a composite of death, nonfatal stroke, nonfatal myocardial infarction, or new renal failure requiring dialysis at 30 days after randomization. RESULTS: There was no significant difference in the rate of the primary composite outcome between off-pump and on-pump CABG (9.8% vs. 10.3%; hazard ratio for the off-pump group, 0.95; 95% confidence interval [CI], 0.79 to 1.14; P=0.59) or in any of its individual components. The use of off-pump CABG, as compared with on-pump CABG, significantly reduced the rates of blood-product transfusion (50.7% vs. 63.3%; relative risk, 0.80; 95% CI, 0.75 to 0.85; P |
| Databáze: | OpenAIRE |
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