The long-term outcomes for patients with left main coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) with drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) are analysed. 

The investigators searched MEDLINE, Embase, and the Cochrane database using the search terms “left main,” “percutaneous coronary intervention” or “stent,” and “coronary artery bypass graft” to identify randomized controlled trials (RCTs), comparing PCI with DES with CABG in patients with left main CAD that had ≥5 years of patient follow-up for all-cause mortality. The primary endpoint was 5-year all-cause mortality. Secondary endpoints were cardiovascular death, spontaneous myocardial infarction (MI), procedural MI, stroke, and repeat revascularization.

Differences in procedural MI between strategies depended on the definition used. Overall, there was no difference in the risk of stroke between PCI and CABG , but the risk was lower with PCI in the first year after randomization.The authors concluded that among patients with left main CAD and, largely, low or intermediate coronary anatomical complexity, there was no statistically significant difference in 5-year all-cause death between PCI and CABG.



Disease Condition ,Therapeutic Modality ,Coronary Artery Disease,Interventional Cardiology,Acute Coronary Syndrome,Myocardial Infarction,STEMI,Percutaneous Coronary Intervention