Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease
An erratum to this article was published (N Engl J Med, 31 Oct 2019 ↗)
Authors' conclusion
In patients with left main coronary artery disease and low or intermediate SYNTAX scores by site assessment, PCI with everolimus-eluting stents was noninferior to CABG with respect to the rate of the composite end point of death, stroke, or myocardial infarction at 3 years.
Study context
- Population
- Patients with left main CAD of low or intermediate anatomical complexity (site-assessed SYNTAX score ≤32)
- Participants
- 1,905 patients
- Comparison
- Percutaneous coronary intervention (PCI) with everolimus-eluting stents vs coronary-artery bypass grafting (CABG)
- PCIn = 948
- CABGn = 957reference
- Primary endpoint
- Composite of:
- Death from any cause
- Stroke
- MI
- Follow-up
- 3 years
Methodological detailsnon-inferiority
- Non-inferiority
Primary result
As reported in the abstract
PCI vs CABGHazard ratio (95% CI)P value
PCI
1.00(0.79–1.26)
P = 0.98 for superiorityNon-inferiority margin 4.2 as printed, not drawn
- Upper 97.5% confidence limit 4.0 percentage points
- difference 0.7 percentage points; P = 0.02 for noninferiority
Secondary outcomes
Death, stroke or MI · 30 days
Death, stroke, MI or ischemia-driven revascularization · 3 years
- Death, stroke or MI: P<0.001 for noninferiority
- Death, stroke or MI: P=0.008 for superiority
- Death, stroke, MI or ischemia-driven revascularization: P=0.01 for noninferiority
- Death, stroke, MI or ischemia-driven revascularization: P=0.10 for superiority
Original publication
Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease. N Engl J Med. Published 31 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it