No Long-Term Advantage Seen for Off-Pump Versus On-Pump CABG

THURSDAY, March 10, 2022 (HealthDay News) -- Coronary artery bypass grafting (CABG) outcomes are similar at 10 years for veterans undergoing "on-pump" or "off-pump" procedures, according to a study published online Feb. 16 in JAMA Surgery.

Jacquelyn A. Quin, M.D., from the Veterans Affairs Boston Healthcare System in West Roxbury, Massachusetts, and colleagues evaluated the 10-year outcomes and costs of off-pump versus on-pump CABG. The analysis included 2,203 veterans randomly assigned to the off-pump group (1,104 patients) or the on-pump group (1,099 patients).

The researchers found that the 10-year death rates were 34.2 percent for the off-pump group and 31.1 percent for the on-pump group (relative risk, 1.05; 95 percent confidence interval, 0.99 to 1.11; P = 0.12). For the off-pump group, the median time to the composite end point (all-cause death or repeated revascularization) was 4.6 years, which was approximately 4.3 months shorter than that for the on-pump group (5.0 years). There were no significant 10-year treatment-related differences for any other primary or secondary end points.

"For veterans, in the absence of contraindications, the traditional on-pump CABG technique should not be supplanted by an off-pump CABG approach," the authors write.

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