PMID- 20237732
OWN - NLM
STAT- MEDLINE
DCOM- 20100713
LR  - 20200825
IS  - 2972-4066 (Electronic)
IS  - 0304-4602 (Linking)
VI  - 39
IP  - 2
DP  - 2010 Feb
TI  - Off-pump versus on-pump coronary artery bypass procedures:postoperative renal 
      complications in an Asian population.
PG  - 112-6
AB  - INTRODUCTION: Diabetes and habitual smoking cause advanced coronary artery 
      disease (CAD) in Asian patients at a younger age. No definite data exist as to 
      whether off-pump (OPCAB) is better than conventional on-pump coronary artery 
      bypass grafting (CCAB) in terms of postoperative renal complications. Thus, we 
      aimed to compare the renal outcomes of on-pump and off-pump coronary artery 
      bypass grafting (CABG) on our patients, which constituted a predominantly Asian 
      population. MATERIALS AND METHODS: A cohort of 395 patients following CCAB were 
      compared with 293 patients who underwent OPCAB. Baseline demographics, 
      comorbidities, intraoperative data, intensive care unit stay, number of grafts, 
      New York Heart Association (NYHA) score, American Society of Anesthesiologists 
      (ASA) score, EuroSCORE risk assessment model, and postoperative complications 
      particularly renal, were collected and analysed. RESULTS: The off-pump group 
      consisted of significantly older patients with higher Canadian Cardiovascular 
      Society (CCS) and ASA scores. Additionally, the off-pump group involved a 
      significantly greater number of smokers and chronic obstructive pulmonary disease 
      (COPD) patients. Other demographic parameters were not different between the 
      groups. Postoperative investigations showed a significantly elevated serum 
      creatinine (100.3 +/- 42.5 vs 127.6 +/- 114.2 micromol/L; off-pump vs on-pump; P 
      = 0.039) and urea levels (5.9 +/- 3.1 vs 10.6 +/- 15.6 mg/dL; off-pump vs 
      on-pump; P = 0.006) in the on-pump group. Moreover, there was a high tendency 
      towards a higher rate of renal dysfunction associated death in this group. 
      CONCLUSIONS: OPCAB is a safe and equally efficient operative method compared to 
      CCAB, and has a significant lower risk for postoperative renal complications as a 
      treatment modality for surgical coronary revascularisation.
FAU - Loganathan, Sivakkanan
AU  - Loganathan S
AD  - Department of Cardiac, Thoracic and Vascular Surgery, National University 
      Hospital, Singapore.
FAU - Nieh, Chih Chiang
AU  - Nieh CC
FAU - Emmert, Maximilian Y
AU  - Emmert MY
FAU - Woitek, Felix
AU  - Woitek F
FAU - Martinez, Eliana C
AU  - Martinez EC
FAU - Muecke, Sonja
AU  - Muecke S
FAU - Lee, Chuen Neng
AU  - Lee CN
FAU - Kofidis, Theo
AU  - Kofidis T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Singapore
TA  - Ann Acad Med Singap
JT  - Annals of the Academy of Medicine, Singapore
JID - 7503289
SB  - IM
MH  - Adult
MH  - Aged
MH  - Asia/ethnology
MH  - Cohort Studies
MH  - Coronary Artery Bypass, Off-Pump/*adverse effects
MH  - Critical Care
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Audit
MH  - Middle Aged
MH  - *Postoperative Complications
MH  - Renal Insufficiency/*etiology
MH  - Singapore
EDAT- 2010/03/20 06:00
MHDA- 2010/07/14 06:00
CRDT- 2010/03/19 06:00
PHST- 2010/03/19 06:00 [entrez]
PHST- 2010/03/20 06:00 [pubmed]
PHST- 2010/07/14 06:00 [medline]
PST - ppublish
SO  - Ann Acad Med Singap. 2010 Feb;39(2):112-6.