De Rosa S, et al. - This study analyzed data from randomized studies comparing coronary artery bypass graft (CABG) with percutaneous coronary intervention with stent implantation (PCI)  for revascularization of left main coronary artery (LMCA). Evidence reported that these two treatment approaches did not differ in the primary analysis on the composite endpoint of death, stroke and myocardial infarction.

Methods

• Researchers searched PubMed, the Chochrane Library and Scopus electronic databases for randomized studies comparing long-term clinical outcomes of CABG or Stent-PCI for the treatment of LMCA disease.
• A total of 5 randomized studies were selected, including 4499 patients.

Results

• Data reported that no significant difference between CABG and PCI was found in the primary analysis on the composite endpoint of death, stroke and myocardial infarction (OR = 1·06 95% CI 0·80–1·40; p = 0·70).
• Similarly, researchers observed no differences between CABG and PCI for all-cause death (OR = 1·03 95% CI 0·81–1·32; p = 0·81).
• Findings demonstrated that although not statistically significant, a lower rate of stroke was registered in the PCI arm (OR = 0·86; p = 0·67), while a lower rate of myocardial infarction was found in the CABG arm (OR = 1·43; p = 0·17).
• On the contrary, data highlighted that a significantly higher rate of repeat revascularization was registered in the PCI arm (OR = 1·76 95% CI 1·45–2·13; p < 0·001).