Coronary disease & ACSCohort study
Percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery disease: the SWEDEHEART registry
- Prospective registry cohort study
- observational
- nationwide
- all-comers
- inverse probability weighting
- instrumental variable analysis
Authors' conclusion
In this non-randomized study, CABG in patients with LMCA disease was associated with lower mortality and fewer MACCE compared to PCI after multivariable adjustment for known and unknown confounders.
Study context
- Population
- Patients with unprotected left main coronary artery disease, SWEDEHEART registry, Sweden, 2005–2015; previous CABG, STEMI or cardiac shock excluded
- Participants
- 11,137 patients
- Exposure
- PCI vs CABG
- PCIn = 1,773
- CABGn = 9,364reference
- Outcome
- Mortality
- Follow-up
- Until 12/31/2015
Main finding
As reported in the abstract
PCI vs CABGHazard ratio (95% CI)
IPW analysis (known confounders)
2.0(1.5–2.7)
IV analysis (known/unknown confounders)
1.5(1.1–2.0)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| MACCE (death, MI, stroke or new revascularization) · IV analysis | 2.8 (1.8–4.5) | |
| 0.20.5125Hazard ratio (log scale) |
Mortality by diabetic status (subgroup)
- Longer median survival time favouring CABG in patients with diabetes
- 3.6 years (95% CI 3.3-4.0)
- interaction P = 0.014
Original publication
PCI or CABG for left main coronary artery disease: the SWEDEHEART registry. Eur Heart J. Published 8 June 2023. doi:10.1093/eurheartj/ehad369
Summarised from the published abstract; every number is checked against it