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CABG Versus PCI: Greater Benefit in Long-Term Outcomes With Multiple Arterial Bypass Grafting
The investigators of this study compared survival of bare metal stent percutaneous coronary intervention (BMS-PCI) versus drug-eluting stent PCI (DES-PCI) versus single artery CABG (SA-CABG) versus multiarterial CABG (MA-CABG) in patients with multivessel coronary artery disease. They used propensity-matching and Cox regression techniques in more than 8000 patients from 1 institution. The authors found that survival after DES-PCI was higher than after BMS-PCI. Long-term survival after DES-PCI was similar to SA-CABG. However, when compared to MA-CABG, the DES-PCI group showed worse survival at 5 years (86.3% versus 95.6%) and at 9 years (82.8% versus 89.8%; HR 0.45, p<0.001). The authors conclude that MA-CABG should be adopted as the optimal therapy for multivessel coronary heart disease.