Tag: EXCEL Trial


PCI vs CABG in Patients with Unprotected Left Main Coronary Artery Disease

Key Takeaways

  • This meta-analysis evaluated 6 randomized controlled trials to determine outcome differences between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) among patients with unprotected left main coronary artery disease ([ULMCAD] n = 4686).
  • Compared with CABG, PCI correlated with significantly lower rates of 30-day stroke (P = 0.007), death or MI (P = 0.04), or all-cause death, MI, or stroke (P = 0.01).
  • In the PCI group, there was a significantly lower rate of 30-day stroke incidence (P = 0.007) and all-cause death, MI, or stroke (P = 0.01).
  • The authors found no significant difference in outcomes at long-term follow-up (median 39 months) between the two groups.
Reference: Palmerini T et al. Am Heart J. 2017;190:54-63.
Continue readingPCI vs CABG in Patients with Unprotected Left Main Coronary Artery Disease

PCI with Everolimus Eluting Stents vs CABG for Left Main Coronary Artery Disease: The EXCEL Trial

Key Takeaways

  • Coronary-artery bypass is a standard treatment of choice for left main coronary artery disease patients, but some trials suggest PCI with stenting could be a good alternative therapeutic option.
  • The EXCEL randomized trial found that complete revascularization via PCI with everolimus-eluting stents is noninferior to CABG for left-main CAD with respect to the study‚Äôs primary and secondary endpoints.
Patients with left main coronary artery disease (CAD) are at a significantly high risk for cardiovascular events due to vessel occlusion that compromises flow in up to three-fourths of the left ventricle. Bypass surgery had been the standard treatment of choice for left main CAD in the past, yet innovations and advancements in cardiology has led to the use of more refined and less invasive therapies. Continue readingPCI with Everolimus Eluting Stents vs CABG for Left Main Coronary Artery Disease: The EXCEL Trial