{"id":"cb91e7d60898","type":"article","url":"https://hartvaat.nl/2016/12/15/off-pump-versus-on-pump-cabg-5-jaarsresultaten-nejm-coronary-trial/","title":"Off-pump versus on-pump CABG: 5-jaarsresultaten NEJM CORONARY-trial","title_en":"Five-Year Outcomes after Off-Pump or On-Pump Coronary-Artery Bypass Grafting.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog"],"tags":["coronaire-bypass"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1601564","source_url":"https://doi.org/10.1056/NEJMoa1601564","authors":["André Lamy","P J Devereaux","Dorairaj Prabhakaran","David P Taggart","Shengshou Hu","Zbynek Straka","Leopoldo S Piegas","Alvaro Avezum","Ahmet R Akar","Fernando Lanas Zanetti","Anil R Jain","Nicolas Noiseux","Chandrasekar Padmanabhan","Juan-Carlos Bahamondes","Richard J Novick","Liang Tao","Pablo A Olavegogeascoechea","Balram Airan","Toomas-Andres Sulling","Richard P Whitlock","Yongning Ou","Peggy Gao","Shirley Pettit","Salim Yusuf"],"significance":8,"published":"2016-12-15","source_date":"2016-12-15","image":"","kennis":[],"congress":"","summary_en":"The 5-year CORONARY results showed no significant difference between off-pump and on-pump CABG for the composite of death, stroke, MI, or renal failure. The large-scale, long-term data supported both surgical approaches as equivalent in skilled centers.","created":"2026-07-03T10:26:28Z","updated":"2026-07-03T13:25:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"NEJM 5-jaarsresultaten van de CORONARY-trial die off-pump vergeleek met on-pump coronaire bypasschirurgie. Een van de grootste gerandomiseerde trials op dit gebied.","abstract_original":"BACKGROUND: We previously reported that there was no significant difference at 30 days or at 1 year in the rate of the composite outcome of death, stroke, myocardial infarction, or renal failure between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report the results at 5 years (the end of the trial). METHODS: A total of 4752 patients (from 19 countries) who had coronary artery disease were randomly assigned to undergo off-pump or on-pump CABG. For this report, we analyzed a composite outcome of death, stroke, myocardial infarction, renal failure, or repeat coronary revascularization (either CABG or percutaneous coronary intervention). The mean follow-up period was 4.8 years. RESULTS: There were no significant differences between the off-pump group and the on-pump group in the rate of the composite outcome (23.1% and 23.6%, respectively; hazard ratio with off-pump CABG, 0.98; 95% confidence interval [CI], 0.87 to 1.10; P=0.72) or in the rates of the components of the outcome, including repeat coronary revascularization, which was performed in 2.8% of the patients in the off-pump group and in 2.3% of the patients in the on-pump group (hazard ratio, 1.21; 95% CI, 0.85 to 1.73; P=0.29). The secondary outcome for the overall period of the trial - the mean cost in U.S. dollars per patient - also did not differ significantly between the off-pump group and the on-pump group ($15,107 and $14,992, respectively; between-group difference, $115; 95% CI, -$697 to $927). There were no significant between-group differences in quality-of-life measures. CONCLUSIONS: In our trial, the rate of the composite outcome of death, stroke, myocardial infarction, renal failure, or repeat revascularization at 5 years of follow-up was similar among patients who underwent off-pump CABG and those who underwent on-pump CABG. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294 .)."}