title: Surgical versus percutaneous revascularization in patients with multivessel coronary artery disease.
abstract: New-generation stents have been continually developed in order to improve the safety and efficacy of percutaneous coronary intervention (PCI). Several randomized clinical trials have been conducted over the last two decades to compare the outcomes of PCI with coronary artery bypass grafting (CABG), which has been the time-tested treatment of multivessel coronary artery disease. The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial is one of the most recent and largest randomized controlled trials comparing PCI using the paclitaxel-eluting first-generation stent with CABG and was uniquely formulated to represent "real world" daily practice. The final 5-year main results of this trial and its various prespecified subgroups have been published in the past year. These results will form the basis of the new guidelines that will be published in the near future. This review is a compilation of the results of the SYNTAX trial and comparisons with other contemporary trials, meta-analyses, and retrospective studies of large registries and how these results help cardiac surgeons and cardiologists in judicious decision-making for their patients with multivessel coronary artery disease requiring revascularization.
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Struempellstraße 39, 04289, Leipzig, Germany, pirarm@hotmail.com.
authors.forename: Piroze M
authors.initials: PM
authors.lastname: Davierwala
authors.forename: Freidrich W
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D003657:Decision Making; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods / Q000401:mortality; D018579:Patient Selection; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome