One-year outcomes of off- and on-pump coronary artery bypass grafting: PROMOTE patency trial

Indian J Thorac Cardiovasc Surg. 2020 Sep;36(5):469-475. doi: 10.1007/s12055-020-00940-1. Epub 2020 Mar 25.

Abstract

Purpose: Earlier we reported 3-month graft patency and clinical outcomes of prospective randomized comparison of off-pump and on-pump multivessel coronary artery bypass surgery to evaluate outcomes and graft patency (PROMOTE patency) trial. We now report major adverse cardiac and cerebrovascular events (MACCE) at 1 year of patients who underwent coronary artery bypass grafting (CABG) using either off-pump technique or on-pump technique.

Methods: The PROMOTE patency trial is a two-arm, prospective, randomized, multicentre trial, and enrolled 320 patients with multivessel coronary artery disease from March 2016 through March 2017 at 6 centres and were randomly assigned to undergo either off-pump CABG (OPCAB) (n = 158 patients) or on-pump CABG (n = 162 patients). The outcomes at 1 year were assessed.

Results: One mortality (0.64%) occurred in off-pump group (at 30 days) and 4 (2.48%) in on-pump group (1 at 30 days, 2 at 3 months, and 1 at 1 year) (p = 0.37). There was no difference between off-pump and on-pump groups in the outcomes of nonfatal myocardial infarction (1 in off-pump and 2 in on-pump group, p = 1.00) and cerebrovascular accident (none in off-pump and 2 in on-pump group, p = 0.49). Repeat revascularization was done in one patient in each group (p = 1.00).

Conclusion: There was no significant difference in the incidence of MACCE between off-pump and on-pump CABG group at 1 year.

Keywords: Coronary artery bypass grafting (CABG); Major adverse cardiac and cerebrovascular events (MACCE).