IRIS-MAIN

This large registry with a median follow-up of 10 years found no detectable difference in all-cause mortality between PCI with drug-eluting stents and CABG for left main disease. It is non-randomised, and although overlap weighting within a target trial emulation framework was used, the authors state that the findings cannot establish causal treatment effects or equivalence in survival. The confidence interval does not exclude a mortality benefit or harm with either strategy. The abstract reports no figures for myocardial infarction, stroke or repeat revascularisation, so the trade-offs beyond survival cannot be judged from it.