Answers are grounded in this paper and cite their sources.
Retrospective cohort study finds lower mortality and adverse events with off-pump bypass in acute myocardial infarction, suggesting potential clinical benefits over on-pump surgery.
Background/Objectives: The comparative efficacy of off-pump and on-pump coronary bypass grafting (CABG) for patients with acute and subacute myocardial infarction (AMI) remains controversial. We compared the outcomes of on-pump versus off-pump coronary artery bypass grafting in Korean patients with acute and subacute myocardial infarction. Methods: This nationwide retrospective cohort study included 14,578 propensity score-matched patients undergoing on-pump or off-pump CABG between 2007 and 2022 using the Korean National Health Insurance Service database. The primary outcomes were recurrent myocardial infarction, repeat revascularization, stroke, all-cause mortality, and major adverse cardiovascular and cerebrovascular events. Chi-square, Kaplan–Meier, and log-rank tests and Cox regression analysis were used. Results: Compared with on-pump CABG, off-pump CABG was associated with significantly lower risks of major adverse cardiovascular and cerebrovascular events (MACCEs), all-cause mortality, and recurrent myocardial infarction in the cause-specific Cox analysis, whereas repeat revascularization and stroke rates were comparable between groups. However, the association with recurrent myocardial infarction was not statistically significant in the Fine–Gray competing-risk analysis. Conclusions: Off-pump CABG was associated with lower risks of all-cause mortality and MACCEs in patients with acute and subacute myocardial infarction. The association with recurrent myocardial infarction was less consistent across analytical approaches and should be interpreted cautiously.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2026) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: