Key result
Off-pump CABG delivers non-inferior ~84% 3-month graft patency versus on-pump CABG in multivessel disease.
Why the study?
The study was conducted to ascertain the non-inferiority of off-pump CABG compared to on-pump CABG regarding angiographically assessed graft patency at 3 months.
Does off-pump CABG provide non-inferior angiographically assessed graft patency at 3 months compared to on-pump CABG in patients undergoing multivessel coronary artery bypass surgery?
RCT (n=300)
Single-blind
1:1 using block randomization, with a block size as 4
Yes
Does off-pump CABG provide non-inferior angiographically assessed graft patency at 3 months compared to on-pump CABG in patients undergoing multivessel coronary artery bypass surgery?
Absolute Event Rate: 84.2% vs 84.4%
p-value: p=0.0001
In patients undergoing multivessel CABG, off-pump surgery showed no significant difference in the completeness of revascularization compared to on-pump surgery.
Off-pump CABG remains appropriate for multivessel disease; reinforces RCT evidence of short-term patency equivalence.
Aim: To ascertain the non-inferiority of off-pump CABG when compared to on-pump CABG in terms of angiographically assessed graft patency at 3 months. Material & Methods: This Prospective Randomized comparison of Off-pump and On-pump Multivessel coronary artery bypass surgery To Evaluate outcomes and graft patency (PROMOTE patency) trial was conducted in Indira Gandhi Institute of medical Sciences, Patna, Bihar, India over a period of one year. Results: A total of 300 patients were enrolled and were randomly assigned to either off-pump CABG (n = 150 patients) or on pump CABG (n = 150 patients). Of 300 patients, 280 patients at 1 month and 295 patients at 3 months survived and were analyzed for MACCE. The incidence of asymptomatic carotid artery stenosis was 0.66% (1 patient) in off-pump and 0.66% (1 patient) in on-pump group, p = 1.01 in our study. No difference was observed between the groups in terms of index of completeness of revascularization (number of grafts performed divided by number of grafts intended) 0.90 vs. 1.00 (p=0.7).
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Kumar et al. (2022) conducted an RCT in Multivessel coronary artery disease (n=300). Off-pump CABG vs. On-pump CABG was evaluated on Grade A graft patency at 3 months (95% CI -0.051 to 0.040, p=0.0001). Off-pump CABG demonstrated non-inferior excellent graft patency at 3 months compared to on-pump CABG (84.2% vs 84.4%, p=0.0001 for non-inferiority) in patients with multivessel coronary artery disease.
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