Abstract:
BACKGROUND:Data from randomized trials evaluating the efficacy of on- versus off-pump coronary artery bypass grafting remain inconclusive, particularly in high-risk populations. AIMS:The aim of this study is to compare the outcomes associated with on- versus off-pump coronary artery bypass grafting among high-risk patients. METHODS:We performed a meta-analysis of randomized control trials comparing on- versus off-pump coronary artery bypass grafting, focusing on high-risk populations. Studies focusing on "high-risk" features: European System of Cardiac Operative Risk Evaluation (EuroSCORE) ≥ 5, age > 70 years, preexisting renal insufficiency, history of stroke(s), and the presence of left ventricular dysfunction were included. MEDLINE, Scopus, and Embase were searched for all publications between January 1, 2000 and August 1, 2016, using the following terms: on-pump, off-pump, coronary artery bypass, high-risk, left ventricular dysfunction, elderly, aged, and renal insufficiency. Endpoints included cardiovascular and all-cause mortality, non-fatal myocardial infarction, stroke, need for revascularization, renal failure, and length of hospital stay. RESULTS:Nine studies incorporating 11,374 patients with a mean age of 70 years were selected. There was no statistical difference in cardiovascular mortality, all-cause mortality, non-fatal myocardial infarction, and renal failure between the two groups. There was a decrease in further revascularization at 1 year with on-pump (OR 0.67 (0.50-0.89)). However, there was an increase in length of hospital stay by 2.24 days (p = 0.03) among the on-pump group with no difference in stroke (OR 1.34 (1.00-1.80)). CONCLUSIONS:On-pump is associated with a decreased risk of additional revascularization by 1 year. However, this appears to be a cost of longer hospitalization.
journal_name
Ir J Med Scijournal_title
Irish journal of medical scienceauthors
Yousif A,Addison D,Lakkis N,Rosengart T,Virani SS,Birnbaum Y,Alam Mdoi
10.1007/s11845-017-1679-8subject
Has Abstractpub_date
2018-05-01 00:00:00pages
369-377issue
2eissn
0021-1265issn
1863-4362pii
10.1007/s11845-017-1679-8journal_volume
187pub_type
杂志文章,meta分析abstract:BACKGROUND:Over the last decade there have been significant changes in the prescribing of antidiabetic therapies. It is of interest to know about these trends and variations in the Irish population so that future prescribing patterns can be estimated. AIMS:To examine the trends in prescribed antidiabetic treatments, i...
journal_title:Irish journal of medical science
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abstract:BACKGROUND:Sport-related concussion (SRC) is a potential issue within Gaelic Football. Therefore, it is essential that concussion management guidelines are adhered to. HYPOTHESIS/PURPOSE:The aim of this study is to determine if potential concussive events (PCEs) in the Gaelic Athletic Association (GAA) National Footba...
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
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