Author + information
- Thiago Scudeler,
- Whady Hueb,
- Patricia Coelho de Soarez,
- Alessandro G. Campolina,
- Paulo Rezende,
- Eduardo Lima,
- Cibele Larrosa Garzillo,
- Diogo Freitas Cardoso Freitas,
- Leandro Costa,
- Fernando Teiichi Oikawa,
- Jose Ramires and
- Roberto Kalil Filho
Background: Long-term costs and quality of life for patients who underwent on-pump and off-pump coronary artery bypass graft surgery (CABG) are unknown.
Methods: Between 2001 and 2006, 308 patients with stable multivessel coronary artery disease and preserved ventricular function were randomized to on-pump CABG (n=153) or off-pump CABG (n=155). The 2 groups were well matched for baseline characteristics. Costs for hospitalizations, physician services, outpatient care, and medications were assigned using 2016 US dollars. Health state utilities were assessed using the SF-6D questionnaire.
Results: On-pump CABG patients received a greater number of grafts per patient (2.97 versus 2.49; P<0.001) and had less incomplete revascularization (42.5% versus 52.9%; P=0.052). QoL improved similarly in both groups from baseline (0.781 vs 0.768, p=0.381) to 6 months (0.817 vs 0.809, p=0.175), 12 months (0.832 vs 0.831, p=0.696), 24 months (0.837 vs 0.827, p=0.349) and 60 months (0.829 vs 0.820, p=0.300). The cumulative QALY adjusted by baseline over 5-year follow-up was higher in on-pump group (3.707; IC 95% 3.678-3.736 and 3.556; IC 95% 3.528-3.585), but not statistically significant. Total costs for the index hospitalization per patient was higher in the off-pump CABG group ($2966.72±381.45 vs $3046.39±890.81, p=0.293). Over the 5-year follow-up, costs were similar between the two treatment groups. Nonetheless, 5-year cumulative cost remained only $180.64 higher per patient with on-pump CABG.
Conclusions: Despite incomplete revascularization following off-pump CABG, there was no difference in QoL and cost-analysis between off-pump and on-pump procedures. QoL markedly improved in both treatment groups over 5-year follow-up.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Revascularization and Myocardial Preservation in Acute and Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1165-308
- 2017 American College of Cardiology Foundation