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PCI and CABG surgery in 2014

CABG surgery versus PCI in CAD—surgery strikes again!

Nature Reviews Cardiology volume 12, pages 75–77 (2015)Cite this article

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Decision-making between percutaneous and surgical revascularization in patients with multivessel coronary artery disease (CAD) is challenging. Current guidelines recommend surgery as the preferred revascularization strategy in patients with multivessel disease, and the 5-year SYNTAX trial results published this year further validates this. However, last-generation drug-eluting stents might challenge surgery in the contemporary setting.

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Figure 1: Recommendation summary for revascularization of stable coronary artery disease.

References

  1. Serruys, P. W. et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N. Engl. J. Med. 360, 961–972 (2009).

    Article  CAS  Google Scholar 

  2. Head, S. J. et al. Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease: final five-year follow-up of the SYNTAX trial. Eur. Heart J. 35, 2821–2830 (2014).

    Article  CAS  Google Scholar 

  3. Morice, M. C. et al. Five-year outcomes in patients with LM disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial. Circulation 129, 2388–2394 (2014).

    Article  Google Scholar 

  4. Windecker, S. et al. 2014 ESC/EACTS guidelines on myocardial revascularization. Eur. Heart J. 35, 2541–2619 (2014).

    Article  Google Scholar 

  5. Patel, M. R., Dehmer, G. J., Hirshfeld, J. W., Smith, P. K. & Spertus, J. A. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update. J. Am. Coll. Cardiol. 59, 857–881 (2012).

    Article  Google Scholar 

  6. Cohen, D. J. et al. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents versus bypass surgery for patients with 3-vessel or LM coronary artery disease: final results from the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation 130, 1146–1157 (2014).

    Article  CAS  Google Scholar 

  7. Sipahi, I., Akay, M. H., Dagdelen, S., Blitz, A. & Alhan, C. Coronary artery bypass grafting vs percutaneous coronary intervention and long-term mortality and morbidity in multivessel disease: meta-analysis of randomized clinical trials of the arterial grafting and stenting era. JAMA Intern. Med. 174, 223–230 (2014).

    Article  Google Scholar 

  8. Bangalore, S. et al. Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. BMJ 347, f6625 (2013).

    Article  Google Scholar 

  9. Stefanini, G. G. et al. Biodegradable polymer drug-eluting stents reduce the risk of stent thrombosis at 4 years in patients undergoing percutaneous coronary intervention: a pooled analysis of individual patient data from the ISAR-TEST 3, ISAR-TEST 4, and LEADERS randomized trials. Eur. Heart J. 33, 1214–1222 (2012).

    Article  CAS  Google Scholar 

  10. Bangalore, S., Toklu, B. & Feit, F. Outcomes with coronary artery bypass graft surgery versus percutaneous coronary intervention for patients with diabetes mellitus: can newer generation drug-eluting stents bridge the gap? Circ. Cardiovasc. Interv. 7, 518–525 (2014).

    Article  Google Scholar 

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Authors and Affiliations

  1. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, 10029, NY, USA

    Gennaro Giustino & Roxana Mehran

Authors
  1. Gennaro Giustino
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  2. Roxana Mehran
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Correspondence to Roxana Mehran.

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Competing interests

R.M. has received institutional research grant support from Bristol–Myers Squibb, Daiichi Sankyo, Lilly, Regado Biosciences, Sanofi-Aventis, STENTYS, and The Medicines Company; is a consultant for Abbott Vascular, AstraZeneca, Boston Scientific, Covidien, CSL Behring, Janssen Pharmaceuticals, Merck, and Sanofi-Aventis; and has equity in and is a shareholder of Endothelix, Inc. G.G. declares no competing interests.

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Giustino, G., Mehran, R. CABG surgery versus PCI in CAD—surgery strikes again!. Nat Rev Cardiol 12, 75–77 (2015). https://doi.org/10.1038/nrcardio.2014.220

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