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Original Articles: Adult Cardiac

Meta-Analysis of On-Pump and Off-Pump Coronary Arterial Revascularization

^a Department of Thoracic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
^b Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China

Accepted for publication November 17, 2008.

^_* Address correspondence to Dr Zhao, Department of Thoracic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Fengyang Rd 415, Shanghai, 200003, China (Email: jimmy-rockingboy{at}163.com).

Background: There is no agreement whether off-pump coronary artery bypass (OPCAB) can reduce mortality, rates of stroke, myocardial infarction, or revascularization when compared with conventional coronary artery bypass (CCAB). We performed a meta-analysis comparing off-pump coronary artery bypass with conventional coronary artery bypass in randomized controlled trials.

Methods: We comprehensively retrieved randomized controlled studies according to predetermined criteria. We performed meta-analyses for each outcome and empirically determined whether potential biases that might result from differences in study design or patient characteristics actually biased the results of a study. We also conducted sensitivity analyses and tested for publication bias.

Results: We undertook a meta-analysis of ten randomized trials (2,018 patients) of OPCAB surgery versus CCAB surgery. No significant differences were found for 1-year mortality (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.75 to 1.33), myocardial infarction (OR, 0.61; 95% CI, 0.44 to 0.84), stroke (OR, 0.56; 95% CI, 0.34 to 0.91), or revascularization (OR, 1.38; 95% CI, 1.00 to 1.92). Therefore, this meta-analysis demonstrates that mortality, stroke, myocardial infarction, and revascularization were not reduced in OPCAB.

Conclusions: In conclusion, OPCAB did not significantly reduce 1-year mortality, stroke, myocardial infarction, and revascularization compared with CCAB.

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