Does percutaneous coronary intervention involving drug-eluting stents compared to CABG affect the need for repeat revascularization and risk of stroke in patients with three-vessel or left main coronary artery disease?
In patients with three-vessel or left main coronary artery disease, CABG offers a lower need for repeat revascularization but a higher risk of stroke compared to PCI with drug-eluting stents.
In the international SYNTAX trial, 1800 patients with three-vessel or left main coronary artery disease were randomly assigned to either revascularization with coronary-artery bypass grafting (CABG) or percutaneous coronary intervention involving drug-eluting stents. The need for repeat revascularization was significantly lower with CABG, but the risk of stroke was significantly higher — a tradeoff that must be considered in making clinical decisions regarding patients with advanced coronary disease. In a roundtable discussion moderated by Dr. Thomas Lee, cardiologists David Hillis and Elizabeth Nabel debate the implications of these findings for clinical practice.View the video of this roundtable discussion, participate . . .
Lee et al. (Wed,) studied this question.