Health-related quality of life following off-pump versus on-pump coronary artery bypass grafting in elderly moderate to high-risk patients: a randomized trial

Østergaard, Birte; Hughes, Pia; Rasmussen, Lars S.; Pedersen, Preben Ulrich; Steinbrüchel, Daniel A.

doi:10.1016/j.ejcts.2006.04.015

Cited by 50 publications

(57 citation statements)

References 30 publications

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“…The fact that G1 patients had higher incidence of stroke in the immediate postoperative period may lead to greater impairment of brain functions and have an impact on the quality of life reported by patients. This observation is consistent with those made by Motallebzadeh et al [1] and Jensen et al [3], whereby the qualities of life are better in both groups, without distinction between them.…”

Section: Discussionsupporting

confidence: 82%

“…Comparative studies using these two methods showed that both present similar results regarding the improved quality of life [1][2][3][4] and the patency of the graft [2,3,5], while several studies have shown some advantages without the use of CPB as lower risk of stroke (CVA), decreased incidence of atrial fibrillation and surgical wound infections [6].…”

Section: Introductionmentioning

confidence: 92%

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Desfechos clínicos pós-revascularização do miocárdio no paciente idoso

Iglézias

Chi

Talans

et al. 2010

Rev Bras Cir Cardiovasc

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Desfechos clínicos pós-revascularização do miocárdio no paciente idoso Outcomes after coronary artery bypass in aged patientsWork performed at the Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. Results: We analyzed 290 patients that possessed appropriate information. The first group G1, of the patients operated without CPB consisted of 111 patients and the second group G2, of the operated ones with CPB consisted of 179 patients. The univariated analysis presented statistics significance for the variables: cardiac insufficiency functional class preoperative (P=0.000), tobacco smoking (P=0.050), number of performed grafts (P=0.050), graft type (P=0.000), associated procedures (P=0.000), preoperative use of intra-aortic balloon (P=0.000), hospital mortality (P=0.000) and type of death (P=0.020). In the postoperative outcomes it was significant only the incidence of brain stroke (CVA) in G2 (P=0.036). In the long term there was higher incidence of reinternment for angina (P=0,038). The analysis of the survival curves presented statistic difference (P=0.009; LogRank Test).Conclusions: CABG without CPB, in this series, proved to be beneficial for the octogenarian patients in the short term, due to the patients having presented lower incidence of brain stroke in the immediate postoperative, whereas in the long term there was higher incidence of re-internments for angina in G1 and higher prevalence of cardiac deaths in G2. Resultados: Na análise univariada apresentaram significância: insuficiência cardíaca congestiva pré-operatória (P=0,000), tabagismo (P=0,050), número de enxertos realizados (P=0,050), tipo de enxerto (P=0,000), procedimentos associados (P=0,000), uso de balão intraaórtico no pós-operatório (P=0,000), óbito hospitalar (P=0,000) e tipo de morte (P=0,020). No pós-operatório imediato, foi significativa apenas a incidência de acidente Descriptors 230 IGLÉZIAS, JCR ET AL -Outcomes after coronary artery bypass in aged patientsRev Bras Cir Cardiovasc 2010; 25(2): 229-233

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 92%

Desfechos clínicos pós-revascularização do miocárdio no paciente idoso

Iglézias

Chi

Talans

et al. 2010

Rev Bras Cir Cardiovasc

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“…6 Studies comparing self-assessed symptoms and quality of life (QoL) in younger patients have failed to show a significant benefit of 1 method over another. [11][12][13][14] Age is an independent predictor of major complications after cardiac surgery. Several authors have claimed that the benefits of OPCAB are more pronounced in elderly patients and patients with high comorbidity.…”

Section: Clinical Perspective On P 2439mentioning

confidence: 99%

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in Elderly Patients

et al. 2012

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for the DOORS Study GroupBackground-Conventional coronary artery bypass grafting performed with the use of cardiopulmonary bypass is a well-validated treatment for patients with ischemic heart disease. Off-pump coronary artery bypass grafting (OPCAB) has been suggested to reduce the number of perioperative complications, especially in elderly patients. Methods and Results-In a multicenter, randomized trial, we assigned 900 patients Ͼ70 years of age to conventional coronary artery bypass grafting or OPCAB surgery. After 30 days, a blinded end-point committee assessed whether a combined end point of death, stroke, or myocardial infarction had occurred. At baseline and 6 months postoperatively, self-assessed quality of life was measured with the Medical Outcomes Study Short Form-36 and EuroQol-5D questionnaires. A 6-month follow-up of mortality was performed through the Danish National Registry. The proportion of patients experiencing the combined end point within 30 days was 10.2% for conventional coronary artery bypass grafting and 10.7% for OPCAB. Implied risk difference of 0.4% (with a 95% confidence interval, Ϫ3.6 to 4.4) showed nonsignificance in a standard test for equality (Pϭ0.83) and for noninferiority with an inferiority margin of 0.5% (Pϭ0.49). At the 6-month follow-up, mortality was 4.7% compared with 4.2% (Pϭ0.75). Both groups showed significant improvement in self-assessed health-related quality of life. Conclusions-Both conventional coronary artery bypass grafting and OPCAB are safe procedures that improved the quality of life when performed in elderly patients. No major differences in intermediate-term outcomes were found. However, the noninferiority of OPCAB with the prespecified margin could not be confirmed. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00123981.

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“…In this questionnaire eight scales cover physical, mental, and social well-being (28). One study found a significantly higher score among CCABG-patients in one of the eight scales ("Role emotional") in contrast to another study who favoured OPCAB patients in the dimension "Social Relationships", using another questionnaire (29,30). In general, few significant inter-group differences have been found, given the multiple tests being performed.…”

Section: Quality Of Lifementioning

confidence: 82%