Coronary disease & ACSRandomised controlled trial
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
- Randomised controlled trial
- open-label
- non-inferiority
- multicentre (36 hospitals)
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
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