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Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients

There is an ongoing debate concerning the optimal surgical option of myocardial revascularization for octogenarians. The current meta‐analysis aimed to compare clinical outcomes following off‐pump coronary artery bypass grafting (OPCABG) or conventional coronary artery bypass grafting (CCABG) in oct...

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Autores principales: Sun, Lifu, Zhou, Meijing, Ji, Yumeng, Wang, Xufeng, Wang, Xiaowei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019872/
https://www.ncbi.nlm.nih.gov/pubmed/35266173
http://dx.doi.org/10.1002/clc.23794
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author Sun, Lifu
Zhou, Meijing
Ji, Yumeng
Wang, Xufeng
Wang, Xiaowei
author_facet Sun, Lifu
Zhou, Meijing
Ji, Yumeng
Wang, Xufeng
Wang, Xiaowei
author_sort Sun, Lifu
collection PubMed
description There is an ongoing debate concerning the optimal surgical option of myocardial revascularization for octogenarians. The current meta‐analysis aimed to compare clinical outcomes following off‐pump coronary artery bypass grafting (OPCABG) or conventional coronary artery bypass grafting (CCABG) in octogenarians. PubMed, Cochrane, Web of Science, and EMBASE databases were searched to identify eligible studies from inception to March 2021. The analysis was performed using STATA 15.1. A literature search yielded 18 retrospective studies involving 146 372 patients (OPCABG = 44 522 vs. CCABG = 101 850). Pooled analysis showed a strong trend toward reducing mortality risk in the OPCABG group (odds ratio: 0.75, 95% confidence interval: 0.56–1.00, p = .05). However, it did not reach statistical significance. The sensitive analysis demonstrated that OPCABG was less likely to cause death than CCABG. There were comparable data in myocardial infarction, renal failure, deep sternal wound infection, and hospital stays between the two groups, although the incidence of stroke, atrial fibrillation, prolonged ventilation, and reoperation for bleeding was significantly lower in the OPCAGB group. OPCABG may be an effective surgical strategy for myocardial revascularization, especially in reducing the incidence of postoperative stroke, atrial fibrillation, prolonged ventilation, and reoperation for bleeding.
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spelling pubmed-90198722022-04-25 Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients Sun, Lifu Zhou, Meijing Ji, Yumeng Wang, Xufeng Wang, Xiaowei Clin Cardiol Review There is an ongoing debate concerning the optimal surgical option of myocardial revascularization for octogenarians. The current meta‐analysis aimed to compare clinical outcomes following off‐pump coronary artery bypass grafting (OPCABG) or conventional coronary artery bypass grafting (CCABG) in octogenarians. PubMed, Cochrane, Web of Science, and EMBASE databases were searched to identify eligible studies from inception to March 2021. The analysis was performed using STATA 15.1. A literature search yielded 18 retrospective studies involving 146 372 patients (OPCABG = 44 522 vs. CCABG = 101 850). Pooled analysis showed a strong trend toward reducing mortality risk in the OPCABG group (odds ratio: 0.75, 95% confidence interval: 0.56–1.00, p = .05). However, it did not reach statistical significance. The sensitive analysis demonstrated that OPCABG was less likely to cause death than CCABG. There were comparable data in myocardial infarction, renal failure, deep sternal wound infection, and hospital stays between the two groups, although the incidence of stroke, atrial fibrillation, prolonged ventilation, and reoperation for bleeding was significantly lower in the OPCAGB group. OPCABG may be an effective surgical strategy for myocardial revascularization, especially in reducing the incidence of postoperative stroke, atrial fibrillation, prolonged ventilation, and reoperation for bleeding. John Wiley and Sons Inc. 2022-03-10 /pmc/articles/PMC9019872/ /pubmed/35266173 http://dx.doi.org/10.1002/clc.23794 Text en © 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Sun, Lifu
Zhou, Meijing
Ji, Yumeng
Wang, Xufeng
Wang, Xiaowei
Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients
title Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients
title_full Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients
title_fullStr Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients
title_full_unstemmed Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients
title_short Off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: A meta‐analysis involving 146 372 patients
title_sort off‐pump versus on‐pump coronary artery bypass grafting for octogenarians: a meta‐analysis involving 146 372 patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019872/
https://www.ncbi.nlm.nih.gov/pubmed/35266173
http://dx.doi.org/10.1002/clc.23794
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