Evidence map›Paper›PMID 41533073›Full record

SynthesisActa diabetologica2026

Clinical outcomes off-pump comparing on-pump coronary artery bypass surgery in diabetic patients: updated systematic review and meta-analysis.

Taher Elmozugi, Hamza Khelifa, Ahmed Badr, Mohamed K Harfoush, Mazen Shehata, Raghad Alganadi, Abdulrahman Ziada, Ibrahim Hegazy, Omar M Ali, Hadeel Khaled Albaoni and 2 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Taher ElmozugiFaculty of Medicine, Benghazi University, Benghazi, Libya. taherelmozugi@gmail.com.ORCID http://orcid.org/0009-0001-5053-4452
Hamza KhelifaFaculty of Medicine, University of Oran, 1 Ahmed Ben Bella, Es Senia, Algeria.
Ahmed BadrFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed K HarfoushFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Mazen ShehataFaculty of Medicine, Modern University for Technology and Information, Cairo, Egypt.
Raghad AlganadiFaculty of Medicine, Modern University for Technology and Information, Cairo, Egypt.
Abdulrahman ZiadaFaculty of Medicine, Tanta University, Tanta, Egypt.
Ibrahim HegazyFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Omar M AliFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Hadeel Khaled AlbaoniJordan University of Science & Technology, Ar-Ramtha, Jordan.
Zina OtmaniFaculty of Medicine, Mouloud Mammeri University, Tizi Ouzou, Algeria.
Motasam Belah Al SwayahFaculty of Medicine, Tripoli University, Tripoli, Libya.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with diabetes mellitus are at high risk for coronary artery disease and frequently undergo coronary artery bypass grafting (CABG). Off-pump CABG (OPCAB) has been proposed to reduce perioperative complications compared with on-pump CABG (ONCAB), but long-term outcomes remain uncertain.

methodsWe conducted a systematic review and meta-analysis in accordance with PRISMA 2020 and Cochrane guidelines. Five databases were searched through May 2025 for randomized trials and observational cohorts comparing OPCAB and ONCAB in adults with diabetes. Risk of bias was assessed using RoB-2 and ROBINS-I, and evidence quality was graded with GRADE.

resultsSeventeen studies were included. No significant differences were observed in 30-day (RR = 0.82, 95% CI: 0.51-1.31; I² = 64%), 1-year (RR = 0.93, 95% CI: 0.56-1.55; I² = 65.6%), or 5-year mortality (RR = 1.09, 95% CI: 0.78-1.53; I² = 58.8%). Randomized data suggested a possible increase in late mortality with OPCAB. OPCAB was associated with lower rates of cerebrovascular events, pulmonary complications, reoperation for bleeding, prolonged ventilation, and intensive care unit stay. No differences were found in myocardial infarction, renal failure, atrial fibrillation, or sternal wound infection. Incomplete revascularization occurred more frequently with OPCAB (RR = 1.96, 95% CI: 1.28-3.0).

conclusionsIn diabetic patients undergoing CABG, OPCAB may reduce postoperative morbidity without altering overall survival. These findings underscore the need to balance perioperative benefits against potential long-term risks when selecting the surgical approach.

Indexed as

Coronary Artery BypassCoronary Artery Bypass, Off-PumpCoronary Artery DiseaseDiabetes MellitusHumansPostoperative ComplicationsRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID41533073

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.