Davierwala PM, Gao C, Thuijs DJFM, et al. - Multiple arterial grafting (MAG) might be more preferable than single arterial grafting (SAG) for coronary artery bypass grafting (CABG) to confer lower long-term all-cause mortality than percutaneous coronary intervention (PCI) in patients with three-vessel (3VD) and/or left main coronary artery disease (LMCAD).

• A post hoc analysis of the SYNTAX Extended Survival Study, wherein PCI was compared with CABG in 3VD and/or LMCAD patients.

• Of 1743 patients, 901 (51.7%) had PCI, 532 (30.5%) had SAG, and 310 (17.8%) had MAG.

• At maximum follow-up (median 11.9 years), all-cause death occurred in 305 (33.9%) PCI, 175 (32.9%) SAG, and 70 (22.6%) MAG patients, respectively.

• MAG [adjusted hazard ratio (HR) 0.66] was linked with significantly lower all-cause mortality than PCI.

• Significantly lower mortality with both MAG and SAG, vs PCI, was noted in 3VD cases.

• In LMCAD cases, no significant differences between PCI and MAG or SAG were seen.

• A positive correlation between the number of myocardial territories receiving arterial grafts and survival was evident in patients with revascularization of all three major myocardial territories.