Revascularisation Strategies for Non-Acute Myocardial Ischaemic Syndromes

An analysis of 10 trials involving more than 10,000 patients with non-acute heart disease compared outcomes for three treatment strategies: optimal medical therapy (OMT), percutaneous coronary intervention (PCI) with OMT, and coronary artery bypass grafting (CABG) with OMT.  
Using a network meta-analysis, scientists found that CABG with OMT was the most effective strategy for reducing long-term mortality, myocardial infarction, and the need for repeat procedures. For example, CABG+OMT had a lower hazard ratio (HR) vs OMT (0.84, 95 percent credible interval (CrI) 0.68−1.07) compared to PCI+OMT vs OMT (0.93, 95 percent CrI 0.79−1.16). The probability of CABG+OMT being the best treatment for mortality was 88.1 percent.