Abstract
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 μmol/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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 112-117 |
| Number of pages | 6 |
| Journal | Annals of the Academy of Medicine Singapore |
| Volume | 39 |
| Issue number | 2 |
| State | Published - Feb 2010 |
| Externally published | Yes |
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Keywords
- Cardiopulmonary bypass
- Renal dysfunction
ASJC Scopus subject areas
- Medicine(all)
Cite this
Off-pump versus on-pump coronary artery bypass procedures : Postoperative renal complications in an asian population. / Loganathan, Sivakkanan; Nieh, Chih Chiang; Emmert, Maximilian Y.; Woitek, Felix; Martinez Valencia, Eliana Cecilia; Muecke, Sonja; Lee, Chuen Neng; Kofidis, Theo.
In: Annals of the Academy of Medicine Singapore, Vol. 39, No. 2, 02.2010, p. 112-117.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Off-pump versus on-pump coronary artery bypass procedures
T2 - Postoperative renal complications in an asian population
AU - Loganathan, Sivakkanan
AU - Nieh, Chih Chiang
AU - Emmert, Maximilian Y.
AU - Woitek, Felix
AU - Martinez Valencia, Eliana Cecilia
AU - Muecke, Sonja
AU - Lee, Chuen Neng
AU - Kofidis, Theo
PY - 2010/2
Y1 - 2010/2
N2 - 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 μmol/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.
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 μmol/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.
KW - Cardiopulmonary bypass
KW - Renal dysfunction
UR - http://www.scopus.com/inward/record.url?scp=77949494515&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77949494515&partnerID=8YFLogxK
M3 - Article
C2 - 20237732
AN - SCOPUS:77949494515
VL - 39
SP - 112
EP - 117
JO - Annals of the Academy of Medicine, Singapore
JF - Annals of the Academy of Medicine, Singapore
SN - 0304-4602
IS - 2
ER -