Effects of Off-Pump and On-Pump Coronary-Artery Bypass Grafting at 1 Year

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art_LAMY_Effects_of_OffPump_and_OnPump_CoronaryArtery_Bypass_Grafting_2013.PDF (555.39 KB)
Citações na Scopus
359
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article
Data de publicação
2013
Editora
MASSACHUSETTS MEDICAL SOC
DOI
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Scopus
Web of Science
PubMed
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Título do Volume
Autores
LAMY, Andre
DEVEREAUX, P. J.
PRABHAKARAN, Dorairaj
TAGGART, David P.
HU, Shengshou
PAOLASSO, Ernesto
STRAKA, Zbynek
PIEGAS, Leopoldo S.
AKAR, Ahmet Ruchan
JAIN, Anil R.
Autor de Grupo de pesquisa
CORONARY Investigators
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Organizadores
Citação
NEW ENGLAND JOURNAL OF MEDICINE, v.368, n.13, p.1179-1188, 2013
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Unidades Organizacionais
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Resumo
BACKGROUND Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outcomes at 1 year. METHODS We enrolled 4752 patients with coronary artery disease who were scheduled to undergo CABG and randomly assigned them to undergo the procedure off-pump or on-pump. Patients were enrolled at 79 centers in 19 countries. We assessed quality of life and cognitive function at discharge, at 30 days, and at 1 year and clinical outcomes at 1 year. RESULTS At 1 year, there was no significant difference in the rate of the primary composite outcome between off-pump and on-pump CABG (12.1% and 13.3%, respectively; hazard ratio with off-pump CABG, 0.91; 95% confidence interval [CI], 0.77 to 1.07; P = 0.24). The rate of the primary outcome was also similar in the two groups in the period between 31 days and 1 year (hazard ratio, 0.79; 95% CI, 0.55 to 1.13; P = 0.19). The rate of repeat coronary revascularization at 1 year was 1.4% in the off-pump group and 0.8% in the on-pump group (hazard ratio, 1.66; 95% CI, 0.95 to 2.89; P = 0.07). There were no significant differences between the two groups at 1 year in measures of quality of life or neurocognitive function. CONCLUSIONS At 1 year after CABG, there was no significant difference between off-pump and on-pump CABG with respect to the primary composite outcome, the rate of repeat coronary revascularization, quality of life, or neurocognitive function. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294.)
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https://observatorio.fm.usp.br/handle/OPI/28056
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03