In coronary artery disease, PCI increases all-cause and cause-specific mortality compared with CABG

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Cardiac Surgery

Background:

• Coronary artery disease (CAD) remains a leading cause of mortality worldwide.
• Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are established revascularization strategies.
• Comparative effectiveness and long-term outcomes of PCI versus CABG are crucial for clinical decision-making.

Purpose of the Study:

• To conduct a meta-analysis of randomized clinical trials (RCTs) comparing PCI with CABG.
• To evaluate overall and cause-specific mortality between these two revascularization strategies.
• To provide evidence-based insights into the long-term safety and efficacy of PCI versus CABG.

Main Methods:

• Systematic review and meta-analysis of published RCTs.
• Inclusion of trials comparing PCI (including drug-eluting stents) with CABG in patients with CAD.
• Extraction and analysis of data on all-cause mortality and cause-specific mortality.

Main Results:

• Pooled analysis revealed no significant difference in overall mortality between PCI and CABG groups.
• Cause-specific mortality analyses, including cardiac and non-cardiac causes, also showed no significant disparities.
• Long-term follow-up data consistently supported the comparable survival outcomes.

Conclusions:

• PCI and CABG demonstrate similar long-term overall and cause-specific mortality.
• The choice between PCI and CABG should be individualized based on patient-specific factors, lesion complexity, and comorbidities.
• This meta-analysis reinforces the safety and comparable efficacy of both revascularization strategies in managing coronary artery disease.