Key result
Review of the NOBLE and EXCEL trials comparing PCI vs CABG for severe unprotected left main coronary artery disease found mixed primary endpoint results and favored CABG for total revascularization.
Only arterial grafts used 14.3% 24.8% Results: PCI vs. CABG Primary endpoint Favors CABG No difference All-cause-mortality No difference No difference Cardiac mortality No difference No difference Total MI NR No difference Spontaneous MI Favors CABG No difference Stroke No difference No difference Total revascularization Favors CABG Favors CABG Target-lesion revascularization No difference No difference LMCA revascularization No difference NR Stent thrombosis 2% † , 0.8% (BIOMATRIX TM DES only) † 0.7% ‡ *, Australia, South America, South Korea; † , based on Kaplan-Meier 5-year estimates; ‡ , based on Kaplan-Meier 3-year estimates.ACS, acute coronary syndrome; DES, drug-eluting stent; IVUS, intra-vascular ultrasound; HR, hazard ratio; LVEF, left ventricular ejection fraction; NR, not reported; NS, not significant; STEMI, ST-segment elevation myocardial infarction; ULMCAD, unprotected left main coronary artery disease.E454 Holmes and Bangalore.
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Holmes et al. (2017) conducted a review in severe unprotected left main coronary artery disease. PCI vs. CABG was evaluated on Primary endpoint. Review of the NOBLE and EXCEL trials comparing PCI vs CABG for severe unprotected left main coronary artery disease found mixed primary endpoint results and favored CABG for total revascularization.
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