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

14 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.

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AU - Gold, Jeffrey P

AU - Wechsler, Andrew S.

AU - Higgins, Robert S.D.

AU - Lahey, Stephen J.

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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 - Mortality

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