Key result
PCI with DES shows comparable 5-year outcomes to CABG for left main CAD.
Why the study?
The role and outcomes of PCI using contemporary drug-eluting stents compared with CABG for left main coronary artery disease remain to be clarified by ongoing trials.
Does percutaneous coronary intervention (PCI) using drug-eluting stents (DES) provide comparable outcomes to coronary artery bypass graft surgery (CABG) in selected patients with left main coronary artery disease?
Does percutaneous coronary intervention (PCI) using drug-eluting stents (DES) provide comparable outcomes to coronary artery bypass graft surgery (CABG) in selected patients with left main coronary artery disease?
PCI with DES is a viable alternative to CABG for selected patients with left main coronary artery disease, with comparable 5-year outcomes in landmark trials.
May support PCI with DES in selected left main disease; leaves open need for updated long-term data.
Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is currently considered as a viable alternative to coronary artery bypass graft surgery (CABG) for selected patients with left main coronary artery disease. The updated results of the landmark randomized trials comparing CABG versus PCI demonstrated comparable 5-year outcomes and are in line with the current guidelines that designate PCI as a reasonable treatment in this disease subset. Given that the completed randomized trials did not include contemporary DESs, the upcoming results of the ongoing trials evaluating the performance of new-generation DES compared with CABG (such as the EXCEL trial), may further help to clarify the current role and future recommendations of PCI for left main coronary artery disease. Apart from the recent stent technology, further improvements in outcomes after PCI may be possible when it is used with an integrated approach that combines functional concepts for decision-making, adjunctive imaging support and optimal pharmacotherapies.
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Lee et al. (2015) conducted a review in left main coronary artery disease. Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) vs. coronary artery bypass graft surgery (CABG) was evaluated. Percutaneous coronary intervention using drug-eluting stents demonstrated comparable 5-year outcomes to coronary artery bypass graft surgery for left main coronary artery disease.
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