Surgery vs. Stenting in Complex Coronary Artery Disease: Mortality at 10 Years

With percutaneous coronary intervention, complete revascularization for patients with 3-vessel or left main disease was key to the best outcome.

In the randomized SYNTAX trial, all-cause mortality at 10 years (NCT03417050) was higher with percutaneous coronary intervention (PCI) than with coronary-artery bypass grafting (CABG) in patients with 3-vessel disease (3VD) but did not differ in those with left main coronary disease (LMD). In a new analysis of the data, researchers examined this outcome based on the completeness of revascularization in 1760 patients (98% of those originally enrolled).

Complete revascularization of all lesions with ≥50% stenosis in vessels ≥1.5 mm diameter was achieved more often with CABG (63%) than PCI (43%). In analyses adjusting for clinical characteristics, 10-year all-cause mortality in patients who achieved complete revascularization was similar for PC…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)