• Stefano Urso, Rafael Sadaba, Jesús María González-Martín, Víctor Dayan, Eliú Nogales, María Ángeles Tena, Cipriano Abad, and Francisco Portela.
• Cardiac Surgery Department, Hospital Universitario Dr Negrín, Las Palmas de Gran Canaria, Spain. Electronic address: stefano_urso@inwind.it.
• J. Thorac. Cardiovasc. Surg. 2024 Jun 1; 167 (6): 21382146.e32138-2146.e3.

ObjectivesWe explored the current evidence on coronary disease treatment comparing the survival of 2 therapeutic strategies: coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stent (DES).MethodsPubMed, Embase, and Google Scholar were searched for randomized clinical trials comparing CABG versus PCI with DES. The end point was overall mortality. Two statistical approaches were used: the generic inverse variance method, which was used to pool the incident rate ratios, and the pooled meta-analysis of Kaplan-Meier-derived individual patient data.ResultsEight randomized clinical trials comparing 4975 patients undergoing CABG and 4992 patients undergoing PCI were included in our meta-analysis. Generic inverse variance method showed a statistically significant survival benefit of the CABG group (incident rate ratio, 1.21; 95% confidence interval, 1.09-1.35; P < .01). The Kaplan-Meier estimates of survival at 1, 5, and 10 years of the CABG group were 97.1%, 90.3%, and 80.3%, respectively. The Kaplan-Meier estimates of survival at 1, 5, and 10 years of the PCI group were 97.0%, 87.7%, and 76.4%, respectively. The log-rank analysis confirmed a statistically significant benefit in term of overall mortality of the CABG group (hazard ratio, 1.24; 95% confidence interval, 1.11-1.38; P = .0001).ConclusionsThe present meta-analysis suggests that CABG provides a consistent survival benefit over PCI with DES.Copyright © 2023 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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