Most Read Articles
Elaine Soliven, 27 Nov 2019
High levels of trunk fat mass (FM) may be associated with an increased risk of cardiovascular disease (CVD)-related events such as coronary death, nonfatal myocardial infarction, or coronary heart disease in postmenopausal women with normal body mass index (BMI), according to a recent study presented at AHA 2019.
28 Nov 2019
Slideshow: Highlights from the American Heart Association (AHA) Scientific Sessions 2019
28 Oct 2019
The C-reactive protein (CRP)-to-albumin ratio (CAR) appears to be linked to the development of acute kidney injury in patients with ST elevation myocardial infarction (STEMI), a recent study has found.
28 Nov 2019
The addition of evolocumab to high-intensity statin therapy is both well tolerated and effective in significantly reducing low-density lipoprotein cholesterol (LDL-C) levels in patients hospitalized for acute coronary syndromes (ACS), allowing most of them to achieve current recommended target levels, a study has shown.

Off-pump CABG tied to higher mortality in patients with left main disease

13 Aug 2019

Off-pump, compared with on-pump, coronary artery bypass grafting (CABG) in patients with left main disease results in a lower rate of revascularization of the coronary arteries supplying the inferolateral wall and an increased risk of 3-year all-cause death, results of the EXCEL* trial have shown.

Of the 923 CABG patients, 652 underwent on-pump surgery and 271 off-pump. The extent of disease was similar between the two groups, but patients in the off-pump arm had a lower rate of revascularization of the left circumflex coronary artery (84.1 percent vs 90.0 percent; p=0.01) and right coronary artery (31.1 percent vs 40.6 percent; p=0.007).

After inverse probability of treatment weighting (IPTW) adjustment for baseline difference, an association was found between off-pump surgery and a significant increase in the risk of 3-year all-cause death (8.8 percent vs 4.5 percent; hazard ratio [HR], 1.94, 95 percent CI, 1.10–3.41; p=0.02), as well as a nonsignificant difference in the risk for the composite endpoint of death, myocardial infarction or stroke (11.8 percent vs 9.2 percent; HR, 1.28, 0.82–2.00; p=0.28).

The EXCEL trial compared percutaneous coronary intervention with everolimus-eluting stents with CABP in patients with left main disease. CABG was performed with or without cardiopulmonary bypass (on-pump vs off-pump surgery) according to the discretion of the operator. IPTW for treatment effect estimation was used to compare the 3-year outcomes in the off-pump and on-pump groups.

“Concerns remain for a greater risk of incomplete revascularization and reduced survival with off-pump CABG surgery compared with on-pump surgery particularly in patients with left main disease and extensive underlying myocardial ischaemia,” the authors said.

*Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Elaine Soliven, 27 Nov 2019
High levels of trunk fat mass (FM) may be associated with an increased risk of cardiovascular disease (CVD)-related events such as coronary death, nonfatal myocardial infarction, or coronary heart disease in postmenopausal women with normal body mass index (BMI), according to a recent study presented at AHA 2019.
28 Nov 2019
Slideshow: Highlights from the American Heart Association (AHA) Scientific Sessions 2019
28 Oct 2019
The C-reactive protein (CRP)-to-albumin ratio (CAR) appears to be linked to the development of acute kidney injury in patients with ST elevation myocardial infarction (STEMI), a recent study has found.
28 Nov 2019
The addition of evolocumab to high-intensity statin therapy is both well tolerated and effective in significantly reducing low-density lipoprotein cholesterol (LDL-C) levels in patients hospitalized for acute coronary syndromes (ACS), allowing most of them to achieve current recommended target levels, a study has shown.