Abstract
Background-Current guidelines recommend coronary artery bypass graft surgery (CABG) when treating significant de novo left main coronary artery (LM) stenosis; however, percutaneous coronary intervention (PCI) has a class IIa indication for unprotected LM disease in selected patients. This analysis compares 5-year clinical outcomes in PCI- and CABG-treated LM patients in the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) trial, the largest trial in this group to date. Methods and Results-The SYNTAX trial randomly assigned 1800 patients with LM or 3-vessel disease to receive either PCI (with TAXUS Express paclitaxel-eluting stents) or CABG. The unprotected LM cohort (N=705) was predefined and powered. Major adverse cardiac and cerebrovascular event rates at 5 years was 36.9% in PCI patients and 31.0% in CABG patients (hazard ratio, 1.23 [95% confidence interval, 0.95-1.59]; P=0.12). Mortality rate was 12.8% and 14.6% in PCI and CABG patients, respectively (hazard ratio, 0.88 [95% confidence interval, 0.58-1.32]; P=0.53). Stroke was significantly increased in the CABG group (PCI 1.5% versus CABG 4.3%; hazard ratio, 0.33 [95% confidence interval, 0.12-0.92]; P=0.03) and repeat revascularization in the PCI arm (26.7% versus 15.5%; hazard ratio, 1.82 [95% confidence interval, 1.28-2.57]; P
| Original language | English |
|---|---|
| Pages (from-to) | 2388-2394 |
| Number of pages | 7 |
| Journal | Circulation |
| Volume | 129 |
| Issue number | 23 |
| DOIs | |
| Publication status | Published - Jun 10 2014 |
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ASJC Scopus subject areas
- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Cite this
Five-Year outcomes in patients with left main disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial. / Morice, Marie Claude; Serruys, Patrick W.; Kappetein, A. Pieter; Feldman, Ted E.; Ståhle, Elisabeth; Colombo, Antonio; Mack, Michael J.; Holmes, David R.; Choi, James W.; Ruzyllo, Witold; Religa, Grzegorz; Huang, Jian; Roy, Kristine; Dawkins, Keith D.; Mohr, Friedrich.
In: Circulation, Vol. 129, No. 23, 10.06.2014, p. 2388-2394.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Five-Year outcomes in patients with left main disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial
AU - Morice, Marie Claude
AU - Serruys, Patrick W.
AU - Kappetein, A. Pieter
AU - Feldman, Ted E.
AU - Ståhle, Elisabeth
AU - Colombo, Antonio
AU - Mack, Michael J.
AU - Holmes, David R.
AU - Choi, James W.
AU - Ruzyllo, Witold
AU - Religa, Grzegorz
AU - Huang, Jian
AU - Roy, Kristine
AU - Dawkins, Keith D.
AU - Mohr, Friedrich
PY - 2014/6/10
Y1 - 2014/6/10
N2 - Background-Current guidelines recommend coronary artery bypass graft surgery (CABG) when treating significant de novo left main coronary artery (LM) stenosis; however, percutaneous coronary intervention (PCI) has a class IIa indication for unprotected LM disease in selected patients. This analysis compares 5-year clinical outcomes in PCI- and CABG-treated LM patients in the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) trial, the largest trial in this group to date. Methods and Results-The SYNTAX trial randomly assigned 1800 patients with LM or 3-vessel disease to receive either PCI (with TAXUS Express paclitaxel-eluting stents) or CABG. The unprotected LM cohort (N=705) was predefined and powered. Major adverse cardiac and cerebrovascular event rates at 5 years was 36.9% in PCI patients and 31.0% in CABG patients (hazard ratio, 1.23 [95% confidence interval, 0.95-1.59]; P=0.12). Mortality rate was 12.8% and 14.6% in PCI and CABG patients, respectively (hazard ratio, 0.88 [95% confidence interval, 0.58-1.32]; P=0.53). Stroke was significantly increased in the CABG group (PCI 1.5% versus CABG 4.3%; hazard ratio, 0.33 [95% confidence interval, 0.12-0.92]; P=0.03) and repeat revascularization in the PCI arm (26.7% versus 15.5%; hazard ratio, 1.82 [95% confidence interval, 1.28-2.57]; P
AB - Background-Current guidelines recommend coronary artery bypass graft surgery (CABG) when treating significant de novo left main coronary artery (LM) stenosis; however, percutaneous coronary intervention (PCI) has a class IIa indication for unprotected LM disease in selected patients. This analysis compares 5-year clinical outcomes in PCI- and CABG-treated LM patients in the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) trial, the largest trial in this group to date. Methods and Results-The SYNTAX trial randomly assigned 1800 patients with LM or 3-vessel disease to receive either PCI (with TAXUS Express paclitaxel-eluting stents) or CABG. The unprotected LM cohort (N=705) was predefined and powered. Major adverse cardiac and cerebrovascular event rates at 5 years was 36.9% in PCI patients and 31.0% in CABG patients (hazard ratio, 1.23 [95% confidence interval, 0.95-1.59]; P=0.12). Mortality rate was 12.8% and 14.6% in PCI and CABG patients, respectively (hazard ratio, 0.88 [95% confidence interval, 0.58-1.32]; P=0.53). Stroke was significantly increased in the CABG group (PCI 1.5% versus CABG 4.3%; hazard ratio, 0.33 [95% confidence interval, 0.12-0.92]; P=0.03) and repeat revascularization in the PCI arm (26.7% versus 15.5%; hazard ratio, 1.82 [95% confidence interval, 1.28-2.57]; P
UR - http://www.scopus.com/inward/record.url?scp=84902268982&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84902268982&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.113.006689
DO - 10.1161/CIRCULATIONAHA.113.006689
M3 - Article
C2 - 24700706
AN - SCOPUS:84902268982
VL - 129
SP - 2388
EP - 2394
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 23
ER -