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Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Trials Surgical ineligibility and mortality among patients with unprotected left main or multivessel coronary artery disease undergoing percutaneous coronary intervention New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative Impact of coronary anatomy and stenting technique on long-term outcome after drug-eluting stent implantation for unprotected left main coronary artery disease EXCELling in Left Main Intervention Differences between the left main and other bifurcations Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease Comparative effectiveness analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease and unprotected left main coronary artery disease Percutaneous Coronary Intervention of Left Main Disease: Pre- and Post-EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) Era

Expert Opinion2017 Feb 28;135(9):819-821.

JOURNAL:Circulation Article Link

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main and Multivessel Coronary Artery Disease: Do We Have the Evidence?

Gersh BJ, Stone GW, Bhatt DL et al. Keywords: coronary artery bypass grafting; coronary artery disease; stenting

ABSTRACT

Approximately 60 randomized controlled trials performed over the last 3 decades have failed to demonstrate statistically significant differences in death or myocardial infarction (MI) between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), apart from a few notable exceptions in which CABG was superior to PCI. The benefits for CABG have been reported in patients with diabetes mellitus with multivessel disease and in patients with and without diabetes mellitus with 3-vessel disease and intermediate or high SYNTAX trial (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) scores (≥23).