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Five-Year Outcomes in Patients with Left Main Disease Treated with Either Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting in the SYNTAX Trial.

Sunday, April 13, 2014

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Source

Source Name: Circulation

Author(s)

Morice MC, Serruys PW, Kappetein AP, Feldman TE, Ståhle E, Colombo A, Mack MJ, Holmes DR, Choi JW, Ruzyllo W, Religa G, Huang J, Roy K, Dawkins KD, Mohr F

This manuscript reports on the 5-year outcomes in the 705 patients with left main (LM) lesions enrolled in the randomized arm of the SYNTAX trial. Follow-up data to 5 years were available in 96.9% of patients who underwent PCI and 92.5% of patients randomized to CABG. Total MACCE at 5 years was 36.9% in patients who received PCI compared with 31.0% in CABG patients (hazard ratio 1.23 [0.95, 1.59]; P=0.12) which was mainly related to differences in repeat revascularization. In the group of patients with high SYNTAX Scores (≥33), MACCE, as well as cardiac death, and revascularization were all significantly increased in patients receiving PCI; whereas stroke and MI occurred at similar rates between treatment arms. The findings suggest that PCI can provide equivalent long-term (to 5 years) death/stroke or MI to CABG, in particular in the subset of LM subjects with SYNTAX Scores <33.

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