Key result
OPCAB compared to traditional CABG showed no significant difference in mortality (5.7% vs 16.2%; RR 3.20, 95% CI 0.67-15.12, p=0.126), but significantly reduced arrhythmia, kidney injury, and stroke.
Why the study?
The benefit of CABG for CAD with low ejection fraction and ischemic burden remains debatable.
Does OPCAB reduce mortality and morbidity compared to traditional CABG in CAD patients with EF <30% and ischemic burden <10%?
Cohort (n=109)
No
Does OPCAB reduce mortality and morbidity compared to traditional CABG in CAD patients with EF <30% and ischemic burden <10%?
Relative Risk: 3.2 (95% CI 0.67–15.12)
Absolute Event Rate: 5.7% vs 16.2%
p-value: p=0.126
In high-risk CAD patients with severe left ventricular dysfunction (EF <30%), OPCAB significantly reduces postoperative morbidity including stroke and kidney injury compared to traditional CABG.
The benefit of coronary artery bypass graft (CABG) for coronary artery disease (CAD) with Ejection Fraction (EF) 30% and ischemic burden (IB) 10% is still debatable. The objective of this study is to analyze mortality and morbidity in patients with EF 30% and ischemic burden 10% undergoing OPCAB compared to traditional CABG (TCABG). The retrospective analytic cohort study was performed using data from January 2015–November 2018 at National Cardiovascular Center Harapan Kita Jakarta, Indonesia. 109 patients were included. 35 patients undergoing OPCAB and 74 patients undergoing TCABG. The primary outcomes were mortality rate, morbidity rate, and length of stay. Arrhythmia is statistically lower in OPCAB compared to TCABG (8.6% vs 39.2%; p=0.001). Kidney injury is statistically lower in OPCAB (8.6% vs 27.0 %; p=0.027). Stroke is statistically lower in OPCAB (1.0 % vs 17.6%; p=0,032). There is no significant difference between OPCAB and TCABG in mortality, 5.7% vs 16.2%, (RR=3.20; CI 95%=0.67–15.12; p= 0.126). There was a statistically significant difference in the occurrence of postoperative morbidity in CAD patients with EF <30% and IB<10% who underwent OPCAB surgery compared with patients who underwent TCABG. Mortality that occurred after OPCAB procedure was lower in CAD patients with EF < 30% and IB<10% compared to TCABG although the statistical difference was not significant. Therefore, patients with this condition are more advisable to undergo OPCAB.
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Suwatri et al. (2021) conducted a cohort in Coronary artery disease with EF <30% and ischemic burden <10% (n=109). OPCAB vs. Traditional CABG (TCABG) was evaluated on Mortality (RR 3.20, 95% CI 0.67-15.12, p=0.126). OPCAB compared to traditional CABG showed no significant difference in mortality (5.7% vs 16.2%; RR 3.20, 95% CI 0.67-15.12, p=0.126), but significantly reduced arrhythmia, kidney injury, and stroke.
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