Pooled data from trials of coronary artery bypass grafting and percutaneous coronary intervention with stenting for multivessel coronary artery disease indicate that PCI is more likely to lead to subsequent adverse events.

Pooled data from trials of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stenting for multivessel coronary artery disease indicate that long-term mortality rates are comparable. However, PCI is more likely to lead to subsequent adverse events and subsequent PCI.

To provide quantitative data on procedure outcomes, Dr. Hisato Takagi and colleagues at Shizuoka Medical Center in Japan conducted a meta-analysis of four randomized controlled trials including more than 3000 patients. The findings are published in the May 1st issue of the American Journal of Cardiology.

During follow-up, which ranged from one to more than five years, the team found no significant differences in the rates of death, cardiac death, Q-wave myocardial infarction, cerebrovascular accidents, and angina pectoris between PCI with stenting and CABG.

However, compared with CABG, PCI with stenting was associated with a significant increase in subsequent PCI, subsequent CABG, and major adverse cardiovascular events as well as subsequent revascularization employing PCI or CABG.

These findings, the team concludes, are in line with those of others which suggest that compared to CABG, PCI with stenting is "fraught with significantly increased risk for subsequent revascularization and major adverse cardiovascular events."