Percutaneous Coronary Intervention with Stenting versus Coronary Artery Bypass Grafting in Stable Coronary Artery...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• The optimal revascularization strategy for stable multivessel coronary artery disease (CAD) remains a subject of ongoing clinical debate.
• Numerous studies have compared coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stent placement, yet definitive conclusions are still sought.

Purpose of the Study:

• To review recent randomized control trials (RCTs) and meta-analyses of pooled RCT data.
• To provide an updated comparison of CABG versus PCI for stable multivessel CAD.
• To inform clinical decision-making regarding revascularization strategies.

Main Methods:

• Systematic review of recent randomized control trials (RCTs).
• Meta-analysis of pooled RCT data.
• Comparative analysis of clinical outcomes between CABG and PCI.

Main Results:

• CABG demonstrated superiority in reducing all-cause mortality and the need for repeat revascularization.
• These benefits of CABG were more pronounced in patients with multivessel CAD and diabetes, and less evident in left main CAD.
• PCI consistently showed a lower incidence of cerebrovascular events compared to CABG.

Conclusions:

• Despite advancements in drug-eluting stent technology, CABG retains significant advantages over PCI for stable multivessel CAD.
• Further research is needed to establish optimal endpoints for comparing PCI and CABG.
• Refining patient selection criteria for both interventions is crucial for personalized treatment strategies.