Meta-analysis of randomized trials comparing the effectiveness of on-pump and off-pump coronary artery bypass / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 338-344, 2012.
Artigo
em Inglês
| WPRIM
| ID: wpr-262613
ABSTRACT
<p><b>BACKGROUND</b>The growing enthusiasm for coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) is emerging, but the role of off-pump coronary artery bypass (OPCAB) in clinical practice remains controversial. The purpose of this study was to assess differences in the incidences of stroke, atrial fibrillation (AF), and myocardial infarction (MI) between OPCAB and conventional coronary artery bypass grafting (CCABG) by meta-analyses of randomized clinical trials.</p><p><b>METHODS</b>A literature search for the period before March 2010 supplemented with manual bibliographic review was performed for all Chinese or English publications in Medline, the Science Citation Index Expanded, the Cochrane Central Register of Controlled Trials (CENTRAL) and CBMdisc. A systematic overview (meta-analyses) of randomized clinical trials was conducted to evaluate the differences between OPCAB and CCABG in the incidences of stroke, AF, and MI. The meta-analysis was performed using RevMan 5 software.</p><p><b>RESULTS</b>Forty-three randomized clinical trials were selected for meta-analysis after screening a total of 356 references, with 8104 patients in the OPCAB group and 8724 cases in the CCABG group. The meta-analyses of these trials showed no significant difference between OPCAB and CCABG in the incidences of stroke (odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.52 - 1.22, P = 0.30) and MI (OR = 0.73, 95%CI = 0.52 - 1.02, P = 0.06). However, we found a significantly reduced risk of AF (OR = 0.65, 95%CI = 0.52 - 0.82, P = 0.0002) in off-pump patients.</p><p><b>CONCLUSIONS</b>Our meta-analyses suggest that OPCAB reduces the risk of postoperative AF compared with CCABG, but there is no significant difference in the incidences of stroke and MI between OPCAB and CCABG.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Fibrilação Atrial
/
Ensaios Clínicos Controlados Aleatórios como Assunto
/
Ponte de Artéria Coronária
/
Incidência
/
Resultado do Tratamento
/
Acidente Vascular Cerebral
/
Ponte de Artéria Coronária sem Circulação Extracorpórea
/
Infarto do Miocárdio
Tipo de estudo:
Ensaio Clínico Controlado
/
Guia de Prática Clínica
/
Estudo de incidência
/
Estudo prognóstico
/
Revisões Sistemáticas Avaliadas
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Chinese Medical Journal
Ano de publicação:
2012
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS