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Title: Effect of Age on Clinical Outcomes Following On-/Off-Pump Coronary Artery Bypass: Meta-Analysis and Meta-Regression
Contributor(s): Mauldon, Hayley (author); Dieberg, Gudrun  (author)orcid ; Smart, Neil  (author)orcid ; King, Nicola  (author)
Publication Date: 2020
Open Access: Yes
DOI: 10.21470/1678-9741-2018-0388
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Abstract: Objective: There is currently much debate about which patients would benefit more after on- or off-pump coronary artery bypass grafting (CABG). The aim of this meta-analysis and meta-regression is to investigate the effect of age on short-term clinical outcomes after these approaches.
Methods: To identify potential studies, systematic searches were carried out in the Excerpta Medica dataBASE (EMBASE), PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL). The search strategy included the key concepts of "cardiopulmonary bypass" AND "coronary artery bypass grafting" AND "off pump" OR "on pump". This was followed by a meta-analysis and meta-regression investigating the effect of age on the incidences of stroke, myocardial infarction (MI), and mortality.
Results: Thirty-seven studies including 15,324 participants were analysed. Overall, there was a significant odds reduction for patients receiving off-pump CABG suffering a stroke (odds ratio [OR] 0.770, 95% confidence intervals [CI] 0.594, 0.998, P=0.048); however, when patients were subdivided according to different age bands, this difference disappeared. There were also no significant differences in the odds of mortality (OR 0.876, 95% CI 0.703, 1.093, P=0.241) or MI (OR 0.937, 95% CI 0.795, 1.105, P=0.439). Meta-regression analysis revealed no significant relationship between age and stroke (P=0.652), age and mortality (P=548), and age and MI (P=0.464).
Conclusion: Patients undergoing CABG are becoming older and may suffer from multiple comorbidities increasing their risk profile. However, with respect to short-term clinical outcomes, the patient’s age does not help in determining whether off- or on-pump is superior.
Publication Type: Journal Article
Source of Publication: Brazilian Journal of Cardiovascular Surgery, 35(5), p. 797-814
Publisher: Brazilian Society of Cardiovascular Surgery
Place of Publication: Brazil
ISSN: 1678-9741
Fields of Research (FoR) 2008: 110201 Cardiology (incl. Cardiovascular Diseases)
Fields of Research (FoR) 2020: 320101 Cardiology (incl. cardiovascular diseases)
Socio-Economic Objective (SEO) 2008: 920103 Cardiovascular System and Diseases
Socio-Economic Objective (SEO) 2020: 200101 Diagnosis of human diseases and conditions
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
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Appears in Collections:Journal Article
School of Science and Technology

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