Evidence map›Paper›PMID 28813218›Full record

Trial reportThe New England journal of medicine2017

Five-Year Outcomes after On-Pump and Off-Pump Coronary-Artery Bypass.

A Laurie Shroyer, Brack Hattler, Todd H Wagner, Joseph F Collins, Janet H Baltz, Jacquelyn A Quin, G Hossein Almassi, Elizabeth Kozora, Faisal Bakaeen, Joseph C Cleveland and 3 more

2 registry-linked trialsAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 97 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 6 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.

NCT01924442 completednot on this map

CSP #517-FS - ROOBY Trial Extension (Randomized on Pump and Off Pump Bypass Surgery: Long Term Follow-up)

TypeobservationalSponsorVA Office of Research and DevelopmentRan2013 to 2018Enrolled2,203ConditionsAll Cause Mortality, MACE
NCT06069986 naunknown statusnot on this mapstarted 2023, after this paper: background citation

On-pump Versus Off-pump Coronary Artery Bypass Grafting , Short Term Outcomes , Sohag Experience

TypeinterventionalSponsorSohag UniversityRan2023 to 2024Enrolled120ConditionsCoronary Artery DiseaseArmscoronary artery bypass graft CABG
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
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  6. Expertise-based design in surgical trials: a narrative review.Canadian journal of surgery. Journal canadien de chirurgie
    Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Article
  11. Article
  12. Article
  13. Combining Surgical and Percutaneous Revascularization for Multivessel Coronary Artery Disease: The Case for a Hybrid Approach.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025
    Article
  14. Life after Coronary Artery Bypass Grafting: Lifestyle Changes, Secondary Prevention, and Quality of Life.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025
    Review
  15. Article
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  20. Review

37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

A Laurie ShroyerFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Brack HattlerFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Todd H WagnerFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Joseph F CollinsFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Janet H BaltzFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Jacquelyn A QuinFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
G Hossein AlmassiFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Elizabeth KozoraFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Faisal BakaeenFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Joseph C ClevelandFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Muath BishawiFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Frederick L GroverFrom Northport Veterans Affairs (VA) Medical Center, Northport, NY (A.L.S., M.B.); Eastern Colorado Health Care System, Department of Veterans Affairs (A.L.S., B.H., J.H.B., J.C.C., F.L.G.), and National Jewish Health (E.K.), Denver; the University of Colorado School of Medicine, Aurora (B.H., J.C.C., F.L.G.); VA Health Economics Resource Center and the Department of Surgery, Stanford University, Palo Alto, CA (T.H.W.); Cooperative Studies Program Coordinating Center, VA Medical Center, Perry Point, MD (J.F.C.); VA Boston Healthcare System, West Roxbury, MA (J.A.Q.); Zablocki VA Medical Center and the Medical College of Wisconsin, Milwaukee (G.H.A.); Cleveland Clinic, Cleveland (F.B.); VA Pittsburgh Health Care System, Pittsburgh (F.B.); and Duke University Medical Center, Durham, NC (M.B.).
Veterans Affairs ROOBY-FS Group

Funding

VA CSP#517-FS
6 · The paper itself

Abstract

backgroundCoronary-artery bypass grafting (CABG) surgery may be performed either with cardiopulmonary bypass (on pump) or without cardiopulmonary bypass (off pump). We report the 5-year clinical outcomes in patients who had been included in the Veterans Affairs trial of on-pump versus off-pump CABG.

methodsFrom February 2002 through June 2007, we randomly assigned 2203 patients at 18 medical centers to undergo either on-pump or off-pump CABG, with 1-year assessments completed by May 2008. The two primary 5-year outcomes were death from any cause and a composite outcome of major adverse cardiovascular events, defined as death from any cause, repeat revascularization (CABG or percutaneous coronary intervention), or nonfatal myocardial infarction. Secondary 5-year outcomes included death from cardiac causes, repeat revascularization, and nonfatal myocardial infarction. Primary outcomes were assessed at a P value of 0.05 or less, and secondary outcomes at a P value of 0.01 or less.

resultsThe rate of death at 5 years was 15.2% in the off-pump group versus 11.9% in the on-pump group (relative risk, 1.28; 95% confidence interval [CI], 1.03 to 1.58; P=0.02). The rate of major adverse cardiovascular events at 5 years was 31.0% in the off-pump group versus 27.1% in the on-pump group (relative risk, 1.14; 95% CI, 1.00 to 1.30; P=0.046). For the 5-year secondary outcomes, no significant differences were observed: for nonfatal myocardial infarction, the rate was 12.1% in the off-pump group and 9.6% in the on-pump group (P=0.05); for death from cardiac causes, the rate was 6.3% and 5.3%, respectively (P=0.29); for repeat revascularization, the rate was 13.1% and 11.9%, respectively (P=0.39); and for repeat CABG, the rate was 1.4% and 0.5%, respectively (P=0.02).

conclusionsIn this randomized trial, off-pump CABG led to lower rates of 5-year survival and event-free survival than on-pump CABG. (Funded by the Department of Veterans Affairs Office of Research and Development Cooperative Studies Program and others; ROOBY-FS ClinicalTrials.gov number, NCT01924442 .).

Indexed as

AgedCardiovascular DiseasesConfounding Factors, EpidemiologicCoronary Artery BypassCoronary Artery Bypass, Off-PumpDisease-Free SurvivalFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedVeterans

Identifiers

PMID28813218

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Registered trials

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 OpenQuestion graph.