Long-term Outcomes After On-Pump vs Off-Pump Coronary Artery Bypass Grafting for Ischemic Cardiomyopathy

Zhou, Zhuoming; Liang, Mengya; Zhuang, Xiaodong; Liu, Menghui; Fu, Guangguo; Liu, Quan; Liao, Xinxue; Wu, Zhongkai

doi:10.1016/j.athoracsur.2021.12.063

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…Although several studies have been compared offpump and on-pump CABG in patients with low EF, the results are conflicting. Few studies showed that OPCABG was associated with lower risk of in-hospital mortality [2,25], and some showed that in-hospital outcomes were the same between OPCABG and ONCABG [31][32][33][34][35]. Regarding mid-and long-term outcomes, in line with our results, some studies showed similar risk between off-and on-pump procedures [33,34].…”

Section: Discussionsupporting

confidence: 88%

“…Few studies showed that OPCABG was associated with lower risk of in-hospital mortality [2,25], and some showed that in-hospital outcomes were the same between OPCABG and ONCABG [31][32][33][34][35]. Regarding mid-and long-term outcomes, in line with our results, some studies showed similar risk between off-and on-pump procedures [33,34]. There are several conducted studies in this field, although none of them consider individuals genomic and epigenomic profiles composed.…”

Section: Discussionsupporting

confidence: 87%

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Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Sheikhy

Fallahzadeh

Forouzannia

et al. 2022

BMC Cardiovasc Disord

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Objective In this study we aimed to compare on-pump and off-pump coronary artery bypass grafting (CABG) outcomes in patients presented with low left ventricular ejection fraction (EF) as a high-risk group of patients. Methods In this registry-based study from 2014 and 2016, all patients with severe left ventricular dysfunction (EF less than 35%) were included and followed until 2020. The median follow-up period was 47.83 [38.41, 55.19] months. Off pump CABG (OPCABG) was compared with on-pump CABG (ONCABG) in terms of mid-term non-fatal cardiovascular events (CVEs) and all-cause mortality. Propensity score method (with inverse probability weighting technique) was used to compare these two groups. Results From 14,237 patients who underwent isolated CABG, 2055 patients with EF ≤ 35% were included; 1705 in ONCABG and 350 patients in OPCABG groups. Although OPCABG was associated with lower risk of 30-days mortality (Odds Ratio [OR]: 0.021; Confidence Interval [CI] 95% [0.01, 0.05], P < 0.001); there was no significant difference between OPCABG and ONCABG in term of mid-term mortality and non-fatal CVEs ((Hazard ratio [HR]: 0.822; 95%CI [0.605, 1.112], p = 0.208) and (HR: 1.246; 95%CI [0.805, 1.929], p = 0.324), respectively). Patients with more than three traditional coronary artery disease risk factors, had more favorable outcomes (in terms of mid-term mortality) if underwent OPCABG (HR: 0.420; 95%CI [0.178, 0.992], p = 0.048). Conclusion OPCABG was associated with lower risk of 30-days mortality; however, mid-term outcomes were comparable in both OPCABG and ONCABG techniques.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Sheikhy

Fallahzadeh

Forouzannia

et al. 2022

BMC Cardiovasc Disord

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“…As mentioned above, all confounding adjustment methods can only control for confounders that are measured. Quantitative bias analysis can be performed to provide insights into the effect of unmeasured confounding under different assumptions, for example, by calculating the E-value [ 14 ] as 4 studies in our review did [ 15 , 26–29 ]. Detailed methods on performing quantitative bias analysis are provided elsewhere [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Confounding adjustment in observational studies on cardiothoracic interventions: a systematic review of methodological practice

Velders,

Boltje,

Vriesendorp

et al. 2023

European Journal of Cardio-Thoracic Surgery

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Objectives It is unknown which confounding adjustment methods are currently used in the field of cardiothoracic surgery and whether these are appropriately applied. The aim of this study was to systematically evaluate the quality of conduct and reporting of confounding adjustment methods in observational studies on cardiothoracic interventions. Methods A systematic review was performed which included all observational studies that compared different interventions and were published between January 1 and July 1, 2022, in three European and American cardiothoracic surgery journals. Detailed information on confounding adjustment methods was extracted and subsequently described. Results Ninety-two articles were included in the analysis. Outcome regression (N = 49, 53%) and propensity score matching (N = 44, 48%) were most popular (sometimes used in combination), while 11 (12%) studies applied no method at all. The way of selecting confounders was not reported in 42 (46%) of the studies, solely based on previous literature or clinical knowledge in 14 (16%), and (partly) data-driven in 25 (27%). For the studies that applied propensity score matching, the matched cohorts comprised on average 46% of the entire study population (range 9% - 82%). Conclusions Current reporting of confounding adjustment methods is insufficient in a large part of observational studies on cardiothoracic interventions, which makes quality judgement difficult. Appropriate application of confounding adjustment methods is crucial for causal inference on optimal treatment strategies for clinical practice. Reporting on these methods is an important aspect of this, which can be improved.

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“…Tuy nhiên, các nghiên cứu gần đây trên các nhóm BMV cụ thể như bệnh nhiều nhánh mạch vành và bệnh nhân có chức năng thất trái giảm lại cho kết quả không có sự khác biệt giữa MACCE, tỷ lệ tái tưới máu và tỷ lệ tử vong khi theo dõi trung hạn 52,53 . Đối với bệnh cơ tim do thiếu máu, OPCAB không cho thấy sự khác biệt về tỷ lệ tử vong khi theo dõi dài hạn khi so với ONCAB 54 . Đặc biệt một tổng quan hệ thống cho thấy OPCAB giảm được biến chứng rung nhĩ sau mổ, tỷ lệ đột quỵ, thời gian thở máy, thời gian nằm hồi sức cũng như nằm viện so với nhóm BCMV có sử dụng tuần hoàn ngoài cơ thể 55 .…”

Section: Theo Thử Nghiệm Syntax (Synergy Between Percutaneousunclassified

Phẫu thuật bắc cầu động mạch vành: Nghệ thuật từ chứng cứ

Phan Quang,

Hồ Đức,

Phạm Trần

et al. 2024

TC Tim mạch học VN

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Phẫu thuật bắc cầu động mạch vành (BCMV) là tiêu chuẩn vàng trong điều trị tái tưới máu động mạch vành trên bệnh nhân đái tháo đường và bệnh nhân có giải phẫu mạch vành phức tạp. Tuy nhiên, vẫn còn nhiều bệnh nhân từ chối phẫu thuật do nhận thức của bệnh nhân về BCMV. Nhận thức này bị ảnh hưởng không chỉ từ cách giao tiếp giữa phẫu thuật viên và bệnh nhân mà còn còn phụ thuộc nhiều vào cách tư vấn của các bác sỹ khác trong đội nhóm tim. Chúng tôi tìm kiếm y văn dựa trên các từ khóa đã liệt kê từ cơ sở dữ liệu của các thư viện y học như PubMed, Embase và Cochrane về chiến lược tiếp cận tối ưu hóa phẫu thuật bắc cầu động mạch vành. Chiến lược tiếp cận phẫu thuật ít xâm lấn và nội soi toàn bộ bằng robot hiện đang là xu thế của BCMV giúp phẫu thuật này giảm thiểu tối đa xâm lấn với bệnh nhân, giúp bệnh nhân dễ dàng chấp nhận phẫu thuật. Ngoài ra, cách giao tiếp với bệnh nhân cũng như chia sẻ kiến thức với bác sĩ nội khoa trong điều trị bệnh mạch vành (BMV) là yếu tố then chốt trong nhóm điều trị BMV giúp chọn lựa phương thức tái tưới máu tối ưu cho bệnh nhân, từ đó không chỉ giúp phát triển điều trị BMV mà còn phát triển cả các phương pháp can thiệp mạch vành hơn nữa.

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Long-term Outcomes After On-Pump vs Off-Pump Coronary Artery Bypass Grafting for Ischemic Cardiomyopathy

Cited by 9 publications

References 25 publications

Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Off-pump versus on-pump coronary artery bypass graft surgery outcomes in patients with severe left ventricle dysfunction: inverse probability weighted study

Confounding adjustment in observational studies on cardiothoracic interventions: a systematic review of methodological practice

Phẫu thuật bắc cầu động mạch vành: Nghệ thuật từ chứng cứ

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