C-50 | Outcomes of Left Main Intervention In Patients Undergoing Percutaneous Coronary Intervention Compared with Coronary Artery Bypass Surgery

The outcome of percutaneous coronary intervention (PCI) of the left main is favorable. In recent years, more studies have compared PCI to coronary artery bypass surgery (CABG). Therefore, we aimed to compare the outcome of PCI compared to CABG using the available data. A total of 6 studies were found that included our criteria comparing PCI vs CABG in left main disease. We used the Mantel-Haenszel method with a random effects model to calculate the pooled odds ratios (OR) with PCI as the experimental and CABG as the control group. A total of 5,795 patients (2,895 in PCI and 2,900 in CABG group) were included. The mean follow-up was 48 months. There was an increased risk of myocardial infarction (OR: 1.49 ; 95% CI = 1.0022 – 2.24; p = 0.04), repeat revascularization (OR: 1.92; 95% CI = 1.55 – 2.37; p < 0.0001) and MACE (OR: 1.5259 ; 95% CI 1.28 - 1.81; p = <0.0001) in the PCI group compared to the CABG group. However, all cause mortality (OR: 1.41; 95% CI = 0.90 – 1.44; p = 0.25), cardiovascular mortality (OR: 1.16; 95% CI = 0.85 – 1.57; p = 0.33), and stroke (OR: 0.71; 95% CI = 0.32 – 1.55; p = 0.39) showed no significance. This meta-analysis showed that there is an increased risk of MI, repeat revascularization, and MACE in patients who are undergoing PCI with left main disease. However, PCI has similar mortality and cardiac death compared to CABG.