A comparison of long-Term mortality for off-pump and on-pump coronary artery bypass graft surgery

Chuntao Wu, Fabian T. Camacho, Alfred T. Culliford, Jeffrey P. Gold, Andrew S. Wechsler, Robert S.D. Higgins, Stephen J. Lahey, Craig R. Smith, Desmond Jordan, Edward L. Hannan

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background-The survival difference between off-pump and on-pump coronary artery bypass graft surgery for follow-up longer than 5 years is not well-understood. The objective of this study is to examine the difference in 7-year mortality after these 2 procedures. Methods and Results-The state of New York's Cardiac Surgery Reporting System was used to identify the 2640 off-pump and 5940 on-pump patients discharged from July through December 2000. The National Death Index was used to ascertain patients' vital statuses through 2007. A logistic regression model was fit to predict the probability of receiving an off-pump procedure using baseline patient characteristics. Off-pump and on-pump patients were matched with a 1:1 ratio based on the probability of receiving an off-pump procedure. Kaplan-Meier survival curves for the 2 procedures were compared using the propensity-matched data, and the hazard ratio for death for off-pump in comparison with on-pump procedures was obtained. In subgroup analyses, the significance of interactions between type of surgery and baseline risk factors was tested. In this study, 2631 pairs of off-pump and on-pump patients were propensity matched. The 7-year Kaplan-Meier survival rates were 71.2% and 73.4% (P<0.07) for off-pump and on-pump surgery, respectively. The hazard ratio for death (off-pump versus on-pump) was 1.10 (95% confidence interval: 0.99 to 1.21, P<0.07). No statistical significance was detected for the interaction terms between the type of surgery and a number of different baseline risk factors. Conclusions-The difference in long-Term mortality between on-pump and off-pump coronary artery bypass graft surgery is not statistically significant.

Original languageEnglish (US)
Pages (from-to)76-84
Number of pages9
JournalCirculation: Cardiovascular Quality and Outcomes
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2012

Fingerprint

Coronary Artery Bypass
Transplants
Mortality
Logistic Models
Off-Pump Coronary Artery Bypass
Kaplan-Meier Estimate
Thoracic Surgery
Survival Rate
Confidence Intervals
Survival

Keywords

  • CAB.G.
  • Coronary artery disease
  • Follow-up studies
  • Mortality
  • Off-pump surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A comparison of long-Term mortality for off-pump and on-pump coronary artery bypass graft surgery. / Wu, Chuntao; Camacho, Fabian T.; Culliford, Alfred T.; Gold, Jeffrey P.; Wechsler, Andrew S.; Higgins, Robert S.D.; Lahey, Stephen J.; Smith, Craig R.; Jordan, Desmond; Hannan, Edward L.

In: Circulation: Cardiovascular Quality and Outcomes, Vol. 5, No. 1, 01.01.2012, p. 76-84.

Research output: Contribution to journalArticle

Wu, C, Camacho, FT, Culliford, AT, Gold, JP, Wechsler, AS, Higgins, RSD, Lahey, SJ, Smith, CR, Jordan, D & Hannan, EL 2012, 'A comparison of long-Term mortality for off-pump and on-pump coronary artery bypass graft surgery', Circulation: Cardiovascular Quality and Outcomes, vol. 5, no. 1, pp. 76-84. https://doi.org/10.1161/CIRCOUTCOMES.111.963124
Wu, Chuntao ; Camacho, Fabian T. ; Culliford, Alfred T. ; Gold, Jeffrey P. ; Wechsler, Andrew S. ; Higgins, Robert S.D. ; Lahey, Stephen J. ; Smith, Craig R. ; Jordan, Desmond ; Hannan, Edward L. / A comparison of long-Term mortality for off-pump and on-pump coronary artery bypass graft surgery. In: Circulation: Cardiovascular Quality and Outcomes. 2012 ; Vol. 5, No. 1. pp. 76-84.
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AU - Camacho, Fabian T.

AU - Culliford, Alfred T.

AU - Gold, Jeffrey P.

AU - Wechsler, Andrew S.

AU - Higgins, Robert S.D.

AU - Lahey, Stephen J.

AU - Smith, Craig R.

AU - Jordan, Desmond

AU - Hannan, Edward L.

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AB - Background-The survival difference between off-pump and on-pump coronary artery bypass graft surgery for follow-up longer than 5 years is not well-understood. The objective of this study is to examine the difference in 7-year mortality after these 2 procedures. Methods and Results-The state of New York's Cardiac Surgery Reporting System was used to identify the 2640 off-pump and 5940 on-pump patients discharged from July through December 2000. The National Death Index was used to ascertain patients' vital statuses through 2007. A logistic regression model was fit to predict the probability of receiving an off-pump procedure using baseline patient characteristics. Off-pump and on-pump patients were matched with a 1:1 ratio based on the probability of receiving an off-pump procedure. Kaplan-Meier survival curves for the 2 procedures were compared using the propensity-matched data, and the hazard ratio for death for off-pump in comparison with on-pump procedures was obtained. In subgroup analyses, the significance of interactions between type of surgery and baseline risk factors was tested. In this study, 2631 pairs of off-pump and on-pump patients were propensity matched. The 7-year Kaplan-Meier survival rates were 71.2% and 73.4% (P<0.07) for off-pump and on-pump surgery, respectively. The hazard ratio for death (off-pump versus on-pump) was 1.10 (95% confidence interval: 0.99 to 1.21, P<0.07). No statistical significance was detected for the interaction terms between the type of surgery and a number of different baseline risk factors. Conclusions-The difference in long-Term mortality between on-pump and off-pump coronary artery bypass graft surgery is not statistically significant.

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KW - Follow-up studies

KW - Mortality

KW - Off-pump surgery

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