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One-year outcomes of off- and on-pump coronary artery bypass grafting: PROMOTE patency trial

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Purpose

Earlier we reported 3-month graft patency and clinical outcomes of prospective randomized comparison of off-pump and on-pump multivessel coronary artery bypass surgery to evaluate outcomes and graft patency (PROMOTE patency) trial. We now report major adverse cardiac and cerebrovascular events (MACCE) at 1 year of patients who underwent coronary artery bypass grafting (CABG) using either off-pump technique or on-pump technique.

Methods

The PROMOTE patency trial is a two-arm, prospective, randomized, multicentre trial, and enrolled 320 patients with multivessel coronary artery disease from March 2016 through March 2017 at 6 centres and were randomly assigned to undergo either off-pump CABG (OPCAB) (n = 158 patients) or on-pump CABG (n = 162 patients). The outcomes at 1 year were assessed.

Results

One mortality (0.64%) occurred in off-pump group (at 30 days) and 4 (2.48%) in on-pump group (1 at 30 days, 2 at 3 months, and 1 at 1 year) (p = 0.37). There was no difference between off-pump and on-pump groups in the outcomes of nonfatal myocardial infarction (1 in off-pump and 2 in on-pump group, p = 1.00) and cerebrovascular accident (none in off-pump and 2 in on-pump group, p = 0.49). Repeat revascularization was done in one patient in each group (p = 1.00).

Conclusion

There was no significant difference in the incidence of MACCE between off-pump and on-pump CABG group at 1 year.

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Acknowledgements

We thank Mr. A. Nadamuni Naidu, M. Sc (Stat), Head, Department of Statistics (Retired), National Institute of Nutrition, ICMR, Hyderabad, India and Trustee, Sajja Heart Foundation, Hyderabad, India for statistical advice and analysis for this study, and we thank all the coordinators of the study from various institutions in coordinating the study: Mr. Mamidala Parusharamulu of Star Hospitals, Hyderabad; Mr. Arnab Naik of Medica Superspeciality, Kolkata; MS. Shashirekha of Krishna Institute of Medical Sciences, Hyderabad; MS. Mahalakshmi Shanmugam of G Kuppuswamy Naidu Memorial Hospital, Coimbatore; Dr. Reenali Bariya of DDMM Heart Institute, Gujarat; and Dr. Neeraj of Fortis Hospital, Mumbai.

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Authors and Affiliations

  1. Division of Cardiothoracic Surgery, Star Hospitals, Road no. 10, Banjara Hills, Hyderabad, AP, 500 034, India

    Lokeswara Rao Sajja & Gopichand Mannam

  2. Division of Cardiothoracic Surgery, Sajja Heart Foundation, Srinagar Colony, Hyderabad, 500 073, India

    Lokeswara Rao Sajja

  3. Division of Cardiothoracic Surgery, Medica Superspeciality Hospital, 127-Mukundapur, EM Bypass, Kolkata, 700025, India

    Kunal Sarkar & Sandip Sardar

  4. Division of Cardiothoracic Surgery, Krishna Institute of Medical Sciences, 1-8-31/1, Minister Road, Secunderabad, Telangana, 500003, India

    Venkata Krishna Kumar Kodali

  5. Division of Cardiothoracic Surgery, G Kuppuswamy Naidu Memorial Hospital, Pappanaickenpalayam, Coimbatore, 641 037, India

    Chandrasekar Padmanabhan

  6. Division of Cardiothoracic Surgery, DDMM Heart Institute, Mission Road, Nadiad, Gujarat, 387 002, India

    Sanjeeth Peter

  7. Division of Cardiothoracic Surgery, Fortis Hospital, Multi-Specialty Hospital Mulund West, Mumbai, 400 078, India

    Anvay Mulay

  8. Division of Clinical Research, Sajja Heart Foundation, Srinagar Colony, Hyderabad, 500 073, India

    Prashanthi Beri

Authors
  1. Lokeswara Rao Sajja
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  2. Kunal Sarkar
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  3. Gopichand Mannam
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  4. Venkata Krishna Kumar Kodali
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  5. Chandrasekar Padmanabhan
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  6. Sanjeeth Peter
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  7. Anvay Mulay
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  8. Sandip Sardar
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  9. Prashanthi Beri
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Corresponding author

Correspondence to Lokeswara Rao Sajja.

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The authors declare that they have no conflict of interest.

Ethical approval

This trial complies with the principles of The Declaration of Helsinki and was approved by the institutional ethics committees of participating institutions.

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All patients signed an informed consent.

Research involving human participants and/or animals

This study complies with the principles of The Declaration of Helsinki and was approved by the institutional ethics committee.

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Sajja, L.R., Sarkar, K., Mannam, G. et al. One-year outcomes of off- and on-pump coronary artery bypass grafting: PROMOTE patency trial. Indian J Thorac Cardiovasc Surg 36, 469–475 (2020). https://doi.org/10.1007/s12055-020-00940-1

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  • DOI: https://doi.org/10.1007/s12055-020-00940-1

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