Why surgery won the SYNTAX trial and why it matters.
The Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) trial cause of death analysis shows that cardiac death due to myocardial infarction is 10 times higher with percutaneous coronary intervention than coronary artery bypass grafting in the higher-risk patients. There was a clear advantage for surgery in the prevention of death in both the intermediate and high SYNTAX score groups with 3-vessel disease and in the high SYNTAX score group with left main disease, and that incremental advantage is statistically significant and widening with time, which should be transparently communicated to patients.
Heart Hospital Baylor Plano, Plano, Tex. Electronic address: Michael.mack@bswhealth.org.
Michael
M
Mack
Heart Hospital Baylor Plano, Plano, Tex.
Heike
H
Baumgarten
Heart Hospital Baylor Plano, Plano, Tex.
Bruce
B
Lytle
D000368:Aged; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D012307:Risk Factors
coronary artery bypass grafting; coronary artery disease; percutaneous coronary intervention