Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial

Friedrich W. Mohr, Marie Claude Morice, A. Pieter Kappetein, Ted E. Feldman, Elisabeth Ståhle, Antonio Colombo, Michael J. MacK, David R. Holmes, Marie Angèle Morel, Nic Van Dyck, Vicki M. Houle, Keith D. Dawkins, Patrick W. Serruys

Research output: Contribution to journalArticlepeer-review

Abstract

Background We report the 5-year results of the SYNTAX trial, which compared coronary artery bypass graft surgery (CABG) with percutaneous coronary intervention (PCI) for the treatment of patients with left main coronary disease or three-vessel disease, to confirm findings at 1 and 3 years. Methods The randomised, clinical SYNTAX trial with nested registries took place in 85 centres in the USA and Europe. A cardiac surgeon and interventional cardiologist at each centre assessed consecutive patients with de-novo three-vessel disease or left main coronary disease to determine suitability for study treatments. Eligible patients suitable for either treatment were randomly assigned (1:1) by an interactive voice response system to either PCI with a first-generation paclitaxel-eluting stent or to CABG. Patients suitable for only one treatment option were entered into either the PCI-only or CABG-only registries. We analysed a composite rate of major adverse cardiac and cerebrovascular events (MACCE) at 5-year follow-up by Kaplan-Meier analysis on an intention-to-treat basis. This study is registered with ClinicalTrials.gov, number NCT00114972. Findings 1800 patients were randomly assigned to CABG (n=897) or PCI (n=903). More patients who were assigned to CABG withdrew consent than did those assigned to PCI (50 vs 11). After 5 years' follow-up, Kaplan-Meier estimates of MACCE were 26•9% in the CABG group and 37•3% in the PCI group (p

Original languageEnglish
Pages (from-to)629-638
Number of pages10
JournalLancet
Volume381
Issue number9867
DOIs
Publication statusPublished - Feb 2013

ASJC Scopus subject areas

  • Medicine(all)

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