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PCI Or CABG - Whats Better For Treating Stable Coronary Artery Disease

Major Study Finds Only CABG Can Prolong Life


A recent study by leading cardiac surgeons proves that CABG is still the way to go.

  • University of Jena
  • Hannover Medical School
  • Imperial College London
  • University Feinberg School of Medicine, Chicago
  • Erasmus University Medical Center, Rotterdam
  • German Heart Institute Berlin
  • Yale School of Medicine, New Haven
  • Heart Center Bad Neustadt
  • Heinrich-Braun-Hospital, Zwickau.

Situation: Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are considered revascularization procedures.

But only CABG can prolong life in stable coronary artery disease.

Thus, PCI and CABG mechanisms may differ.

Viability and/or ischemia detection to guide revascularization have been unable to accurately predict treatment effects of CABG or PCI, questioning a revascularization mechanism for improving survival.

By contrast, preventing myocardial infarction may save lives. However, the majority of infarcts are generated by non-flow-limiting stenoses, but PCI is solely focused on treating flow-limiting lesions.

Thus, PCI cannot be expected to significantly limit new infarcts, but CABG may do so through providing flow distal to vessel occlusions.

All comparisons of CABG to PCI or medical therapy that demonstrate survival effects with CABG also demonstrate infarct reduction.

Thus, CABG may differ from PCI by providing "surgical collateralization," prolonging life by preventing myocardial infarctions.

The evidence is reviewed here.

Link to study: https://pubmed.ncbi.nlm.nih.gov/30819365/

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