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63 Percutaneous coronary intervention vs coronary artery bypass grafting in left main coronary artery disease: A systematic review and updated meta-analysis

Aim There is still no consensus whether percutaneous coronary intervention (PCI) is as safe and effective as coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) disease. Until recently, European and US guidelines recommended CABG as the standard of care for LMCA disease management. However numerous recent studies suggest that PCI with drug eluting stents (DES) has a low risk of mortality at medium and long-term follow-up after left main stenting. This has resulted in European guidelines suggesting that PCI may be effective in treating anatomically simple LMCA disease, while CABG is still the gold standard for more complex lesions. These changes have been largely informed by six RCTs which have compared PCI vs CABG in LMCA disease. However, the results of these studies have not been straightforward, with often conflicting results. The con-tinuing lack of consensus coupled with the recent publication of 5- and 10-year data from some of these studies necessitated an updated systematic review and meta-analysis. systematic of the MEDLINE (via PubMed), RCTs which compared PCI CABG in minimum follow-up of and to report all-cause as an outcome