Evidence map›Paper›PMID 25968885›Full record

Trial reportEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2016

On-pump versus off-pump coronary artery bypass graft surgery among patients with type 2 diabetes in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial.

Ashima Singh, Hartzell V Schaff, Maria Mori Brooks, Mark A Hlatky, Stephen R Wisniewski, Robert L Frye, Edward Y Sako, BARI 2D Study Group

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Predialysis coronary revascularization and postdialysis mortality.The Journal of thoracic and cardiovascular surgery · 2019
    Observational
  7. Predictors of Quality of Life Improvement after 2 Years of Coronary Artery Bypass Surgery.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2017
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Ashima SinghDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Hartzell V SchaffDivision of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
Maria Mori BrooksDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Mark A HlatkyDepartment of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA.
Stephen R WisniewskiDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Robert L FryeDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Edward Y SakoDepartment of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA sako@uthscsa.edu.
BARI 2D Study Group

Funding

BARI II:Foreign RecruitmentU01HL061744 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2000 to 2005
$41.1M
BARI II - FIBRINOLYSIS AND COAGULATION COREU01HL063804 · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · 2000 to 2005
$3.3M
ECONOMIC OUTCOMES OF TREATMENT STRATEGIES IN BAR1-2U01HL061748 · STANFORD UNIVERSITY · 2000 to 2005
$2.1M
BARI II GRANT PROPOSAL FOR ECG CORE LABORATORYU01HL061746 · SAINT LOUIS UNIVERSITY · 2000 to 2005
$1.2M
NHLBI NIH HHS R21 HL121495NHLBI NIH HHS R21HL121495NHLBI NIH HHS U01 HL061744NHLBI NIH HHS U01 HL061746NHLBI NIH HHS U01 HL061748NHLBI NIH HHS U01 HL063804
6 · The paper itself

Abstract

objectivesConclusive evidence is lacking regarding the benefits and risks of performing off-pump versus on-pump coronary artery bypass graft (CABG) for patients with diabetes. This study aims to compare clinical outcomes after off-pump and on-pump procedures for patients with diabetes.

methodsThe Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial enrolled patients with type 2 diabetes and documented coronary artery disease, 615 of whom underwent CABG during the trial. The procedural complications, 30-day outcomes, long-term clinical and functional outcomes were compared between the off-pump and on-pump groups overall and within a subset of patients matched on propensity score.

resultsOn-pump CABG was performed in 444 (72%) patients, and off-pump CABG in 171 (28%). The unadjusted 30-day rate of death/myocardial infarction (MI)/stroke was significantly higher after off-pump CABG (7.0 vs 2.9%, P = 0.02) despite fewer complications (10.3 vs 20.7%, P = 0.003). The long-term risk of death [adjusted hazard ratio (aHR): 1.41, P = 0.2197] and major cardiovascular events (death, MI or stroke) (aHR: 1.47, P = 0.1061) did not differ statistically between the off-pump and on-pump patients. Within the propensity-matched sample (153 pairs), patients who underwent off-pump CABG had a higher risk of the composite outcome of death, MI or stroke (aHR: 1.83, P = 0.046); the rates of procedural complications and death did not differ significantly, and there were no significant differences in the functional outcomes.

conclusionsPatients with diabetes had greater risk of major cardiovascular events long-term after off-pump CABG than after on-pump CABG.

Indexed as

Coronary Artery BypassCoronary Artery Bypass, Off-PumpCoronary Artery DiseaseDiabetes Mellitus, Type 2Diabetic AngiopathiesFemaleHumansMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationPostoperative ComplicationsPropensity ScoreStrokeCoronary arteries bypass graftDiabetic patientsOff-pump procedure

Identifiers

PMID25968885
PMCPMC4711702

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.