Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease

Patrick W. Serruvs, Marie Claude Morice, A. Pieter Kappetein, Antonio Colombo, David R. Holmes, Michael J. Mack, Elisabeth Ståhle, Ted E. Feldman, Marcel Van Den Brand, Eric J. Bass, Nic Van Dyck, Katrin Leadley, Keith D. Dawkins, Friedrich W. Mohr

Research output: Contribution to journalArticle

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Abstract

BACKGROUND Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary-artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating patients with previously untreated three-vessel or left main coronary artery disease (or both). METHODS We randomly assigned 1800 patients with three-vessel or left main coronary artery disease to undergo CABG or PCI (in a 1:1 ratio). For all these patients, the local cardiac surgeon and interventional cardiologist determined that equivalent anatomical revascularization could be achieved with either treatment. A noninferiority comparison of the two groups was performed for the primary end point - a major adverse cardiac or cerebrovascular event (i.e., death from any cause, stroke, myocardial infarction, or repeat revascularization) during the 12-month period after randomization. Patients for whom only one of the two treatment options would be beneficial because of anatomical features or clinical conditions, were entered into a parallel, nested CABG or PCI registry. Results Most of the preoperative characteristics were similar in the two groups. Rates of major adverse cardiac or cerebrovascular events at 12 months were significantly higher in the PCI group (17.8%, vs. 12.4% for CABG; P=0.002), in large part because of an increased rate of repeat revascularization (13.5% vs. 5.9%, P

Original languageEnglish
Pages (from-to)961-972
Number of pages12
JournalNew England Journal of Medicine
Volume360
Issue number10
DOIs
Publication statusPublished - Mar 5 2009

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Percutaneous Coronary Intervention
Coronary Artery Bypass
Coronary Artery Disease
Drug-Eluting Stents
Random Allocation
Registries
Cause of Death
Therapeutics
Stroke
Myocardial Infarction

ASJC Scopus subject areas

  • Medicine(all)

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Serruvs, P. W., Morice, M. C., Kappetein, A. P., Colombo, A., Holmes, D. R., Mack, M. J., ... Mohr, F. W. (2009). Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. New England Journal of Medicine, 360(10), 961-972. https://doi.org/10.1056/NEJMoa0804626

Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. / Serruvs, Patrick W.; Morice, Marie Claude; Kappetein, A. Pieter; Colombo, Antonio; Holmes, David R.; Mack, Michael J.; Ståhle, Elisabeth; Feldman, Ted E.; Van Den Brand, Marcel; Bass, Eric J.; Van Dyck, Nic; Leadley, Katrin; Dawkins, Keith D.; Mohr, Friedrich W.

In: New England Journal of Medicine, Vol. 360, No. 10, 05.03.2009, p. 961-972.

Research output: Contribution to journalArticle

Serruvs, PW, Morice, MC, Kappetein, AP, Colombo, A, Holmes, DR, Mack, MJ, Ståhle, E, Feldman, TE, Van Den Brand, M, Bass, EJ, Van Dyck, N, Leadley, K, Dawkins, KD & Mohr, FW 2009, 'Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease', New England Journal of Medicine, vol. 360, no. 10, pp. 961-972. https://doi.org/10.1056/NEJMoa0804626
Serruvs, Patrick W. ; Morice, Marie Claude ; Kappetein, A. Pieter ; Colombo, Antonio ; Holmes, David R. ; Mack, Michael J. ; Ståhle, Elisabeth ; Feldman, Ted E. ; Van Den Brand, Marcel ; Bass, Eric J. ; Van Dyck, Nic ; Leadley, Katrin ; Dawkins, Keith D. ; Mohr, Friedrich W. / Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. In: New England Journal of Medicine. 2009 ; Vol. 360, No. 10. pp. 961-972.
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AU - Holmes, David R.

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AU - Ståhle, Elisabeth

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AU - Van Den Brand, Marcel

AU - Bass, Eric J.

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AU - Leadley, Katrin

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