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Acta Diabetologica

Erschienen in:

30.12.2016 | Original Article

Off-pump versus on-pump coronary artery bypass grafting in patients with diabetes: a meta-analysis

verfasst von: Yushu Wang, Xiuli Shi, Rongsheng Du, Yucheng Chen, Qing Zhang

Erschienen in: Acta Diabetologica | Ausgabe 3/2017

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Abstract

Aims

The effects of off-pump CABG (OFF-CABG) versus on-pump CABG (ON-CABG) in diabetic patients remain controversial. The aim of our study was to compare mortality and postoperative morbidity between OFF-CABG and ON-CABG for diabetic patients.

Methods

Electronic databases including PubMed, EMBASE and Cochrane Library for studies investigating clinical outcomes of OFF-CABG versus ON-CABG in diabetic patients were searched, collecting data from inception until June 2016. We pooled the odds ratios from individual studies and performed heterogeneity, quality assessment and publication bias analysis.

Results

A total of 543,220 diabetic patients in 10 studies were included. The overall mortality (OR, 0.87; 95% CI, 0.58–1.31; p = 0.50) was comparable between the OFF-CABG and ON-CABG. OFF-CABG was associated with significantly fewer cerebrovascular accidents (OR, 0.45; 95% CI, 0.31–0.65; p < 0.0001), bleeding complications (OR, 0.59; 95% CI, 0.43–0.80; p < 0.001) and pulmonary complications. However, no differences in myocardial infarction (OR, 0.76; 95% CI, 0.52–1.12; p = 0.16), renal failure (OR, 0.74; 95% CI, 0.50–1.11; p = 0.14) and other postoperative morbidity outcomes were found.

Conclusions

OFF-CABG significantly reduces the incidence of postoperative cerebrovascular accidents and bleeding complications compared with ON-CABG in diabetic patients. No differences were found regarding mortality, myocardial infarction and renal failure between these two techniques. Our study suggests that OFF-CABG may be an optimal strategy for diabetic patients although adequately powered randomized trials are needed to further verify the finding.

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Titel: Off-pump versus on-pump coronary artery bypass grafting in patients with diabetes: a meta-analysis
verfasst von: Yushu Wang
Xiuli Shi
Rongsheng Du
Yucheng Chen
Qing Zhang
Publikationsdatum: 30.12.2016
Verlag: Springer Milan
Erschienen in: Acta Diabetologica / Ausgabe 3/2017
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-016-0951-0

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