Rationale and design of the coronary artery bypass grafting surgery off or on pump revascularization study: a large international randomized trial in cardiac surgery
Am Heart J
; 163: 1-6, 2012.
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1059423
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
Background Uncertainty remains regarding the benefits and risks of the technique of operating on a beating heart(off pump) for coronary artery bypass grafting (CABG) surgery versus on-pump CABG. Prior trials had few events and relativelyshort follow-up. There is a need for a large randomized, controlled trial with long-term follow-up to inform both the short- andlong-term impact of the 2 approaches to CABG.Methods We plan to randomize 4,700 patients in whom CABG is planned to undergo the procedure on pump or offpump. The coprimary outcomes are a composite of total mortality, myocardial infarction (MI), stroke, and renal failure at30 days and a composite of total mortality, MI, stroke, renal failure, and repeat revascularization at 5 years. We will alsoundertake a cost-effectiveness analysis at 30 days and 5 years after CABG surgery. Other outcomes include neurocognitivedysfunction, recurrence of angina, cardiovascular mortality, blood transfusions, and quality of life.Results As of May 3, 2011, CORONARY has recruited N3,884 patients from 79 centers in 19 countries. Currently,patient's mean age is 67.6 years, 80.7% are men, 47.0% have a history of diabetes, 51.4% have a history of smoking, and34.4% had a previous MI. In addition, 20.9% of patients have a left main disease, and 96.6% have double or triplevessel disease.Conclusions CORONARY is the largest trial yet conducted comparing off-pump CABG to on-pump CABG. Its resultswill lead to a better understanding of the safety and efficacy of off-pump CABG. (Am Heart J 2012;1631-6.)
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Ischemic Heart Disease
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Thoracic Surgery
/
Coronary Artery Bypass, Off-Pump
/
Myocardial Infarction
Type of study:
Controlled clinical trial
Language:
English
Journal:
Am Heart J
Year:
2012
Document type:
Article
Institution/Affiliation country:
National Coordination Office/IN
/
Ankara University School of Medicine and Ankara University Stem Cell Institute/TR
/
Centre Hospitalier Universitaire de Montreal (CHUM)/CA
/
Fuwai Hospital/CN
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Instituto de Investigaciones Clínicas de Rosario (IICR)/AR
/
Population Health Research Institute/CA
/
SAL Hospital and Medical Institute/IN
/
Third Faculty of Medicine/CZ
/
Universidad de La Frontera/CL