Causes of Death Following PCI Versus CABG
In an analysis from the SYNTAX trial that randomized PCI vs CABG in patients with complex coronary disease, Milojevic et al found that patients had significantly higher rates of cardiac death after PCI, which was particularly caused by significantly higher rates of myocardial infarction-related death. This analysis is the first in-depth study on specific causes of death from a trial comparing PCI and CABG.
The introduction doesn’t say whether the patients are from the same institution and I wonder if the PCI patients were give an opportunity for surgery or are the PCI patients in an institution that does not have PCI surgical back up.
Syntax Trial:
N Engl J Med 2009; 360:961-972March 5, 2009DOI: 10.1056/NEJMoa0804626
Additionally, the five year follow up of the SYNTAX trial had been completed almost two years ago with the very clear evidence, that either modality – by the patient preference) only advised to be chosen in the subgroup of patients with one vessel disease and good left ventricular function. The more complex the IHD (coronaries with DVD TVD) the clearer the indication for surgical revascularization based upon the above mentioned end points after one year.