A meta-analysis for the incidence of postoperative myocardial infarction after off-pump and on-pump coronary artery bypass surgery / 中华胸心血管外科杂志

ABSTRACT

Objective The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) as comparing with conventional coronary artery bypass grafting(CCABG) remain inconclusive in randomized, controlled trials and retrospective studies. We tried to assess the incidence of myocardial infarction (MI) after OPCAB and CCABG. with a meta analysis based on published data in randomized ,controlled trials. Methods Relevant randomized controlled trials, published in English and Chinese before January 2009, were searched in Medline, the Science Citation Index Expanded, the Cochrane Central Register of Controlled Trials (CENTRAL) and CBMdisc. Manual searching of bibliographies were performed, with key words "oronary artery bypass graft", "off-pump" and "myocardial infarction". Two reviewers selected eligible trials independently, performed quality assessment and collected relevant data. Meta-analysis was performed with software RevMan 5. Results 22 trials were considered to be eligible for the meta analysis. The incidence of MI was 2.81% (42/1494) in the OPCAB group as compared with 3.57% (54/1512) in the CCABG group. No significant difference was present between the two groups (OR =0.80,95% CI =0.54 - 1.20, P =0.28). Conclusion Our meta analysis of current available randomized controlled trials involving OPCAB and CCABG in patients with coronary artery diseases suggests that the difference in the incidence of postoperative MI between CCABG and OPCAB groups is not significant.