A systematic review and meta-analysis of randomized controlled studies comparing off-pump versus on-pump coronary artery bypass grafting in the elderly

• Tipo: Outra Publicação em Revista Científica Internacional
• Data: 2022

Autores

Machado, RJ (Autor) Outra; Saraiva, FA (Autor) Outra; Mancio, J (Autor) FMUP; Sousa, P (Autor) Outra; Cerqueira, RJ (Autor) Outra; Barros, AS (Autor) Outra; Andre P Lourenco (Autor) FMUP; Leite Moreira, AF (Autor) Outra

Revista

Título: Journal of Cardiovascular Surgery

Vol. 63

Páginas: 60-68

ISSN: 0021-9509

Editora: EDIZIONI MINERVA MEDICA

Indexação

ISI Web of Knowledge - 5 Citações

Outras Informações

ID Authenticus: P-00W-9NY

DOI: 10.23736/s0021-9509.21.12012

Abstract (EN): INTRODUCTION: Comparison of short and mid-term outcomes between off-pump CABG (OPCAB) and on-pump CABG (ONCAB) in patients older than 65 throughout a meta-analysis of randomized clinical trials (RCTs). EVIDENCE ACQUISITION: A literature search was conducted using 3 databases. RCTs reporting mortality outcomes of OPCAB versus ONCAB among the elderly were included. Data on myocardial infarction, stroke, re-revascularization, renal failure and composite endpoints after CABG were also collected. Random effects models were used to compute statistical combined measures and 95% confidence intervals (CI). EVIDENCE SYNTHESIS: Five RCTs encompassing 6221 patients were included (3105 OPCAB and 3116 ONCAB). There were no significant differences on mid-term mortality (pooled HR: 1.02, 95%CI: 0.89-1.17, P=0.80) and composite endpoint incidence (pooled HR: 0.98, 95%CI: 0.88-1.09, P=0.72) between OPCAB and ONCAB. At 30-day, there were no differences in mortality, myocardial infarction, stroke and renal complications. The need for early re-revascularization was significantly higher in OPCAB (pooled OR: 3.22, 95%CI: 1.28-8.09, P=0.01), with a higher percentage of incomplete revascularization being reported for OPCAB in trials included in this pooled result (34% in OPCAB vs. 29% CONCLUSIONS: Data from RCTs in elderly patients showed that OPCAB and ONCAB provide similar mid-term results. OPCAB was associated with a higher risk of early re-revascularization. As CABG on the elderly is still insufficiently explored, further RCTs, specifically designed targeting this population, are needed to establish a better CABG strategy for these patients. (Cite this article as: Machado RJ, Saraiva FA, Mancio J, Sousa P, Cerqueira RJ, Barros AS, et al. A systematic review and meta-analysis of randomized controlled studies comparing off-pump versus on-pump coronary artery bypass grafting in the elderly. J Cardiovasc Surg 2022;63:60-8. DOI:

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9