SYNTAX

SYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery

Doente / População Intervenção / Exposição Comparação Desfecho

In 1,800 patients with 3-vessel or left main coronary disease, PCI with paclitaxel-eluting stents increased 12-month death, stroke, MI, or repeat revascularisation compared with CABG.

1800

Desenho

Multicentre all-comers RCT, non-inferiority

Desfecho

MACCE (death, stroke, MI, or repeat revascularisation) at 12 months

Relevância

ResultadoPCI 17.8% vs CABG 12.4% (P=0.002); non-inferiority not met, driven by more repeat revascularisation with PCI (13.5% vs 5.9%). Stroke higher with CABG (2.2% vs 0.6%).

Serruys PW, et al. N Engl J Med. 2009;360(10):961-72. 10.1056/NEJMoa0804626

Discussão e crítica

Used obsolete first-generation paclitaxel stents and failed a non-inferiority design, so not a clean superiority test. Established the anatomic SYNTAX score and the Heart Team principle that CABG is preferred for complex 3-vessel/left-main disease.