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Eur J Cardiothorac Surg 2004;26:81-84
© 2004 Elsevier Science NL
a Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, The Netherlands
b Department Cardiothoracic Surgery, Heart Lung Centre Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
c Department of Cardiology, Heart Lung Centre Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
Received 12 January 2004; received in revised form 16 March 2004; accepted 22 March 2004.
* Corresponding author. Address: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Internal Postal address Str 6.131, P.O. Box 85500, Utrecht 3508 GA, The Netherlands. Tel.: +31-30-2509377; fax: +31-30-2505485
e-mail: g.vanderheijden{at}umcutrecht.nl
Objective: To assess the effect of conventional coronary artery bypass surgery (CABG) compared to the off-pump procedure (OPCAB). Methods: Based on randomised trials found in PubMed and Science Citation Index, an overall odds ratio and 95% confidence interval was calculated for the combined endpoint of mortality, stroke and myocardial infarction. Results: The 18 randomised trials included 1584 patients (783 OPCAB, 801 CABG). The odds ratio was 0.73 (95% CI=0.26; 2.04) at 2-week post-surgery, 0.75 (0.39; 1.42) at 1-month post-surgery, 0.55 (0.28; 1.08) at 3-month post-surgery, and 0.66 (0.38; 1.15) at 1-year post-surgery. Conclusions: The outcome of this meta-analysis shows favourable results for OPCAB for the combined endpoint of mortality, stroke and myocardial infarction at short and long term follow-up. However, none of the risk reductions reach statistical significance at the conventional level. Based on our results OPCAB appears to be equivalent to CABG.
Key Words: Off-pump coronary bypass surgery • Meta-analysis • Randomised trials
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