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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe Coronary Artery Bypass Grafting Surgery Off- or On-Pump Revascularization Study [CORONARY; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00463294\u0026amp;atom=%2Fspmdc%2F12%2F4%2F13.1.atom\u0022\u003ENCT00463294\u003C\/a\u003E] was designed to test the hypothesis that off-pump CABG would reduce short-term (30 days) major clinical events and that these benefits would be maintained over the long term (5 years). This article discusses the short-term study results.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EResults of a study that was designed to compare the benefits and risks of performing coronary artery bypass grafting surgery (CABG) off\u2013pump (beating heart) versus on\u2013pump showed no difference in major clinical events at 30 days, with off\u2013pump procedures associated with reduced rates of transfusions, reoperations for bleeding, acute kidney injury, and respiratory infection\/failure but an increased rate of early repeat revascularizations.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe Coronary Artery Bypass Grafting Surgery Off\u2013or On\u2013Pump Revascularization Study [CORONARY; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00463294\u0026amp;atom=%2Fspmdc%2F12%2F4%2F13.1.atom\u0022\u003ENCT00463294\u003C\/a\u003E] was designed to test the hypothesis that off\u2013pump CABG would reduce short\u2013term (30 days) major clinical events and that these benefits would be maintained over the long term (5 years). The short\u2013term study results were presented by Andre Lamy, MD, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003ECORONARY was a randomized, double\u2013blind international trial (79 centers in 19 countries). Eligibility included patients who were undergoing planned isolated CABG with median sternotomy and at least 1 of the following risk factors: age \u226570 years, peripheral vascular disease, cerebrovascular disease, carotid stenosis \u0026gt;70%, and renal insufficiency. Patients were also eligible if they were aged 60 to 69 and years had at least 1 \u003Cem\u003Eadditional\u003C\/em\u003E risk factor or were aged 55 to 59 years with at least 2 \u003Cem\u003Eadditional\u003C\/em\u003E risk factors\u2014diabetes, urgent revascularization, smoker, or left ventricular ejection fraction (LVEF) \u2264 35%. Each operation was performed by a surgeon with expertise (\u0026gt;2 years; \u0026gt;100 procedures) in the specific type of surgery that the patient was assigned to receive. The first coprimary outcome was a composite of mortality, nonfatal stroke, nonfatal myocardial infarction (MI), and new renal failure that required dialysis at 30 days. The 5\u2013year results will be available in 2016 and comprise the first coprimary outcome plus repeat coronary revascularization at a mean of 5 years. Secondary efficacy outcomes included rates of blood transfusion, recurrent angina, cardiovascular death, and cost\u2013effectiveness.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EA total of 4572 subjects (mean age 68 years) participated in the study. Most (81%) were men, and one\u2013third had a prior MI. Baseline preoperative angiograms indicated that the majority (off\u2013pump 56.1%; on\u2013pump 60.4%) had triple\u2013vessel disease. At 30 days, 9.8% and 10.3% of patients who received off\u2013pump versus on\u2013pump procedures reached the primary composite outcome (HR, 0.95; 95% CI, 0.79 to 1.14; p=0.59). Off\u2013pump CABG was associated with significantly fewer blood transfusions and reoperation for bleeding, less acute kidney injury, and fewer respiratory complications but more early repeat coronary revascularizations (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). No difference in primary outcome was noted at hospital discharge, nor were there any differences by subgroup.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/13995\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/13995\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13995\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EOutcomes at 30 Days.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EThe investigators concluded that in experienced hands, both procedures are reasonable options, based on short\u2013term results. The difference in morbidity that was observed in the 30\u2013day results may or may not lead to clinically significant differences during the long\u2013term follow\u2013up that is being conducted. Whether the unblinded nature of the trial (both patients and investigators were aware of study group assignment, but the endpoint adjudication committee members were unaware) or this interim report will bias the long\u2013term follow\u2013up of trial patients is unclear [Lamy A et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2012].\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/4\/13.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznhc1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nznhc1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}