Percutaneous coronary intervention vs. coronary artery bypass graft – a review of 5 year outcomes

This study investigated the long-term outcomes of percutaneous coronary intervention (PCI) compared to coronary artery bypass surgery (CABG) in patients with blockages in the left main coronary artery.

They found that PCI was less effective than CABG in these patients.

Coronary artery disease (CAD) is caused by blockages in the arteries that supply blood to the heart. This leads to reduced blood flow to the heart. This can lead to a heart attack or death. There are several ways to manage CAD. A procedure can be performed to remove a blockage and restore blood flow. This is called revascularization (RV). The most common RV procedure is coronary artery bypass surgery (CABG). This surgical procedure uses a piece of vascular tissue to by-bass the area with the blockage. 

Another RV procedure is percutaneous coronary intervention (PCI). PCI is minimally invasive. A stent (thin tube) is delivered to the area by a catheter. The stent keeps the artery open to allow blood flow. Some studies suggest PCI has similar benefits to CABG. The success of RV is measured by the rate of major adverse cardiac and cerebrovascular (brain) events (MACCE). It is unclear if the long-term effect of PCI on MACCE is similar to CABG.

This study included 1184 patients with CAD. Patients underwent either PCI or CABG for left main artery CAD. The primary outcome was the occurrence of MACCE. Patients were followed up for an average of 4.9 years.

MACCE rates were 28% for PCI and 19% for CABG. The risk of MACCE was 58% higher with PCI. Mortality rates were similar in both groups. The risk of a heart attack was 2.99 times greater after PCI. Patients that underwent PCI were 73% more likely to need another RV procedure after 5 years. 

The authors concluded that PCI was less effective compared to CABG in patients with left main CAD in the long-term.

If you have any concerns regarding CAD management please consult with your physician.