The Eternal Debate With a Consistent Answer: CABG vs PCI

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Cardiac Surgery

Background:

• Debate persists regarding optimal revascularization for multivessel or left main coronary artery disease.
• Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are primary treatment options.
• Advancements in stent technology have improved PCI outcomes.

Purpose of the Study:

• To review and synthesize evidence comparing PCI and CABG for revascularization in complex coronary artery disease.
• To evaluate long-term outcomes based on recent randomized controlled trials and meta-analyses.

Main Methods:

• Systematic review of randomized controlled trials (RCTs).
• Inclusion of meta-analyses published within the last 4 years.
• Focus on patient populations with multivessel or left main coronary artery disease.

Main Results:

• Coronary artery bypass grafting (CABG) demonstrates superior long-term clinical outcomes compared to percutaneous coronary intervention (PCI) in most patients.
• Despite technological advancements, surgical revascularization remains the preferred strategy for complex disease.
• Analysis of recent data reinforces the established benefits of CABG.

Conclusions:

• Coronary artery bypass grafting (CABG) is recommended for long-term revascularization in patients with multivessel or left main coronary artery disease.
• Percutaneous coronary intervention (PCI) may be considered in select cases, but CABG offers better durability.
• Evidence from recent trials supports CABG as the gold standard for these patient groups.