Off-Pump versus On-Pump Coronary Artery Bypass Grafting in Prefrail and Frail Patients: 30-Day and 1-Year Outcomes From the FRAGILE Randomized Trial.

In prefrail and frail CABG patients, off-pump versus on-pump surgery showed similar 30-day composite event rates (10.9% vs 16.0%), with no significant difference.

• Why it matters: Frailty predicts worse CABG outcomes, but it is unclear whether off-pump or on-pump techniques offer comparative benefit in prefrail and frail patients.
• What they did: FRAGILE, a multicenter randomized open-label trial (Jan 2018–Dec 2024) assigned 508 patients ≥60 years to OPCAB (n=258) or ONCAB (n=250) and compared 30-day composite outcomes using intention-to-treat relative risks.
• The result: Surgical wound infection was higher with ONCAB (8.0% vs 3.5%; P=0.04), while neurocognitive and quality-of-life outcomes at 1 year were not significantly different; 1-year survival probabilities were 96.1% vs 92.8% (P=0.099).

AI summary of the abstract · may contain errors · not medical advice · read the paper.