The 85-center SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) trial compared percutaneous coronary intervention (PCI) with coronary-artery bypass grafting (CABG) for treating patients with previously untreated three-vessel or left main artery disease. The primary endpoints for the study included the following: death from any cause, stroke, myocardial infarction, and repeat revascularization. These variables were measured up to 12 months after treatment. Between the two interventions, the study found no difference in rates of death
or myocardial infarction. The incidence of stroke was higher in the
CABG group (2.7% vs. 0.3% with PCI; p=0.01). The rates for combined major adverse cardiac or cerebrovascular events were however higher in the PCI group (17.8% vs. 12.4% with CABG; p=0.002). This difference was largely attributed to a significant difference in the rate of repeat revascularization (13.5% vs. 5.9% with CABG; p<0.001).

The authors conclude that “CABG, as compared with PCI, is associated with a lower rate of major adverse cardiac or cerebrovascular events at 1 year among patients with three-vessel or left main coronary artery disease (or both) and should therefore remain the standard of care for such patients.”

• Source
• Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, Ståhle E, Feldman TE, van den Brand M, Bass EJ, Van Dyck N, Leadley K, Dawkins KD, Mohr FW; the SYNTAX Investigators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009