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The Eternal Debate With a Consistent Answer: CABG vs PCI.

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Percutaneous coronary intervention versus coronary artery bypass grafting for multivessel or left main disease shows bypass surgery offers superior long-term results. This review analyzes recent trials and meta-analyses on revascularization strategies.

Keywords:
Coronary artery bypass graftingMeta-analysisMyocardial revascularizationPercutaneous coronary interventionRandomized controlled trials

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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.