van der Heijden Geert J M G, Nathoe Hendrik M, Jansen Erik W L, Grobbee Diederick E
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur J Cardiothorac Surg. 2004 Jul;26(1):81-4. doi: 10.1016/j.ejcts.2004.03.032.
To assess the effect of conventional coronary artery bypass surgery (CABG) compared to the off-pump procedure (OPCAB).
Based on randomised trials found in PubMed and Science Citation Index, an overall odds ratio and 95% confidence interval was calculated for the combined endpoint of mortality, stroke and myocardial infarction.
The 18 randomised trials included 1584 patients (783 OPCAB, 801 CABG). The odds ratio was 0.73 (95% CI=0.26; 2.04) at 2-week post-surgery, 0.75 (0.39; 1.42) at 1-month post-surgery, 0.55 (0.28; 1.08) at 3-month post-surgery, and 0.66 (0.38; 1.15) at 1-year post-surgery.
The outcome of this meta-analysis shows favourable results for OPCAB for the combined endpoint of mortality, stroke and myocardial infarction at short and long term follow-up. However, none of the risk reductions reach statistical significance at the conventional level. Based on our results OPCAB appears to be equivalent to CABG.
评估传统冠状动脉搭桥手术（CABG）与非体外循环冠状动脉搭桥手术（OPCAB）相比的效果。
基于在PubMed和科学引文索引中找到的随机试验，计算死亡率、中风和心肌梗死联合终点的总体优势比和95%置信区间。
18项随机试验纳入了1584例患者（783例OPCAB，801例CABG）。术后2周时优势比为0.73（95%CI=0.26；2.04），术后1个月时为0.75（0.39；1.42），术后3个月时为0.55（0.28；1.08），术后1年时为0.66（0.38；1.15）。
该荟萃分析结果显示，在短期和长期随访中，OPCAB在死亡率、中风和心肌梗死联合终点方面有良好结果。然而，在传统水平上，风险降低均未达到统计学显著性。基于我们的结果，OPCAB似乎与CABG等效。
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