Coronary disease & ACS

Percutaneous coronary intervention versus coronary artery bypass grafting for unprotected left main stenosis: 10-year final results from the randomised, open-label, non-inferiority NOBLE trial

LancetPublished Randomised controlled trial

Primary result · All-cause mortalityResult — go to the resultHazard ratio 0.93 95% CI 0.74–1.18

Authors' conclusion

There was no significant difference in all-cause mortality at 10 years between PCI and CABG for patients with unprotected left main coronary artery disease and no additional complex lesions, indicating that PCI is equally as safe as CABG in patients eligible for both treatments.

Study context

Population
Patients with unprotected left main coronary artery stenosis (chronic or acute coronary syndrome), eligible by heart team, 9 European countries1,184 in ITT population
Participants
1,201 patients
Comparison
Percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG)
  • PCIn = 598
  • CABGn = 603reference
Primary endpoint
All-cause mortality (ITT)
Follow-up
10 years
Methodological detailsopen-label, non-inferiority, multicentre (36 hospitals)
  • Open-label
  • Non-inferiority
  • Multicentre (36 hospitals)

Primary result

All-cause mortality

Hazard ratio

0.93

95% CI 0.74–1.18

P = 0.56

Events by treatment group

PCI vs CABG
HR 0.93 (95% CI 0.74–1.18); P = 0.56

As reported in the abstract

Further findings

All-cause mortality by SYNTAX score (subgroup)

No significant difference in all-cause mortality with SYNTAX score

Original publication

Percutaneous coronary intervention versus coronary artery bypass grafting for unprotected left main stenosis: 10-year final results from the randomised, open-label, non-inferiority NOBLE trial. Lancet. Published 4 April 2026. doi:10.1016/s0140-6736(26)00205-9

Summarised from the published abstract; every number is checked against it

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