10-year outcomes of off-pump vs on-pump CABG in Department of Veterans Affairs patients

Editor's Note

This multi-center, randomized, clinical trial that compares on-pump coronary artery bypass grafting (CABG) with off-pump CABG finds no advantage for off-pump CABG.

A total of 2,203 veterans were randomly assigned to off-pump (1,104) or on-pump (1,099) CABG procedures at 18 VA medical centers, and the veterans were then observed for 10 years.

Among the findings:

• 10-year death rates were 34.2% for off-pump and 31.1% for on-pump patients.
• Median time to composite end point (died or had subsequent revascularization) was 4.6 years for off-pump and 5.0 years for on-pump patients.
• No significant differences in secondary outcomes (ie, PCIs, repeat CABG, clinically relevant cardiac symptoms, costs) were found between off-pump and on-pump groups.

No tangible long-term advantages of off-pump CABG were identified, compared with the traditional on-pump technique, the researchers say.