Outcome of percutaneous coronary intervention compared to coronary artery bypass grafting in left main coronary artery stenosis: a systematic review

Abstract

Background: Coronary artery bypass graft (CABG) surgery has been recommended as the standard treatment for patients with left main coronary artery (LMCA) disease. However, with advances in interventional cardiology, percutaneous coronary intervention (PCI) has been increasingly used for LMCA disease although long-term outcomes comparing PCI with CABG remain limited. Objectives: This systematic review was performed using PubMed/MEDLINE, ScienceDirect, and Google Scholar databases to analyze PCI and CABG’s effects on patients with coronary artery disease. Methods: This systematic review used all studies on the differences in PCI and CABG intervention outcomes in left main coronary artery stenosis. This search yielded 1,427 studies, of which 18 studies were included for the final analysis. In the studies, 62,632 patients were treated with PCI and CABG. A total of 17 studies stated that CABG provides better outcomes than PCI. However, one study stated otherwise. Conclusion: Other factors that also affect PCI or CABG outcomes include patient risk factors before revascularization, SYNTAX score, and gender. Among LMCA stenosis patients, CABG is associated with lower incidence of mortality, repeat revascularization, myocardial infarction, and MACE than PCI. Meanwhile, PCI results in lower stroke incidence.