A Meta-analysis Of Randomized Trials For Long-term Major Complications Following Off-pump Versus On-pump Coronary Artery Bypass Grafting

Objective:Off-pump and on-pump coronary artery bypass grafting are two major surgical procedures for coronary artery bypass grafting. We conducted a meta-analysis of randomized trials to compare the long-term complications of these two surgical procedures. Methods:CNKI, WanFangData, VIP, PubMed, EMBASE and the Cochrane Central Register were searched for Randomized Controlled Trials(RCTs) that compare the long-term complications of off-pump and on-pump coronary artery bypass grafting. According to the Cochrane system evaluation method, the quality of the research literature was evaluated by the inclusion and exclusion criteria, and the RevMan5.2 software was used for meta analysis. Results:A total of 9 studies were included, including 11660 patients, 5794 patients in the experimental group and 5866 cases in the control group. There were no significant differences between the experimental group and the control group in mortality [OR=1.10, 95%CI(0.94,1.30),P=0.22] and myocardial infarction [OR =0.90, 95%CI(0.76,1.06),P=0.21]. However, the differences were statistically significant between the two groups in revascularization [OR=1.41, 95%CI(1.09,1.83),P=0.009] and stroke [OR=0.75, 95%CI(0.57,0.98),P=0.04]. Conclusion: There are no significant differences between the experimental group and the control group in mortality and myocardial infarction. The evidence suggests that there appears to be a beneficial effect of on-pump coronary artery bypass grafting on revascularization. However, off-pump coronary artery bypass grafting appears to reduce the risks of stroke.